ALT与AST比值预测慢性丙型肝炎患者肝脂肪变性的可行性分析

张秀丽

doi:10.3969/j.issn.1001-5256.2017.06.016

ALT与AST比值预测慢性丙型肝炎患者肝脂肪变性的可行性分析

DOI: 10.3969/j.issn.1001-5256.2017.06.016

张秀丽

南阳市第一人民医院检验科

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中图分类号: R512.63
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出版历程
- 收稿日期: 2016-12-26
- 出版日期: 2017-06-20

Feasibility of alanine aminotransferase/aspartate aminotransferase ratio in predicting hepatic steatosis in chronic hepatitis C patients

Zhang XiuLi

Department of Clinical Laboratory, The First People's Hospital of Nanyang

摘要

摘要: 目的评价ALT/AST值预测慢性丙型肝炎（CHC）患者肝脂肪变性程度的可行性。方法选择2012年5月-2016年6月就诊于南阳市第一人民医院的CHC患者231例,其中非酒精性脂肪性肝病（NAFLD）患者105例（45.45%）,非NAFLD患者126例（54.55%）;同时根据B超评分将NAFLD组分为轻中度（12分）脂肪变性组（n=67）和重度（3分）脂肪变性组（n=38）。比较NAFLD组和非NAFLD组人口学及肌酐、空腹血糖、ALT、AST、ALT/AST、GGT、尿酸、LDL、HDL、CHO、TG等病情资料,筛选CHC合并NAFLD的独立危险因素。符合正态分布的计量资料组间比较采用独立样本t检验;不符合正态分布的数据组间比较采用Wilcoxon秩和检验;计数资料组间比较采用χ2检验;以重度NAFLD为因变量,不同因素引入logostic回归方程筛选独立危险因素。结果NAFLD组收缩压、舒张压、空腹血糖、ALT、ALT/AST值、GGT、HDL、CHO、TG和糖尿病、高血压、代谢综合征比例高于非NAFLD组（P值均<0.05）;轻中度组收缩压、舒张压、...
- 肝炎,丙型,慢性 /
- 脂肪肝 /
- 丙氨酸转氨酶 /
- 天冬氨酸氨基转移酶类
Abstract: Objective To investigate the feasibility of alanine aminotransferase (ALT) /aspartate aminotransferase (AST) ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC) patients. Methods A total of 231 CHC patients who visited The First People's Hospital of Nanyang from May 2012 to June 2016 were enrolled, among whom 105 (45. 45%) had nonalcoholic fatty liver disease (NAFLD) and 126 (54. 55%) did not have NAFLD. According to the ultrasound score, the NAFLD group was divided into mild-to-moderate (1-2 points) hepatic steatosis group (n = 67) and severe (3 points) hepatic steatosis group (n = 38) . The two groups were compared in terms of demographic data and disease data including creatinine, fasting blood glucose, ALT, AST, ALT/AST ratio, γ-glutamyltransferase (GGT) , uric acid, low-density lipoprotein, high-density lipoprotein (HDL) , cholesterol (CHO) , and triglyceride (TG) to screen out independent risk factors for NAFLD in CHC patients. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; with severe NAFLD as the dependent variable, different factors were introduced into the logistic regression equation to screen out independent risk factors. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as well as a significantly higher proportion of patients with diabetes, hypertension, or metabolic syndrome (all P < 0. 05) . Compared with the severe hepatic steatosis group, the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as well as a significantly lower proportion of patients with diabetes, hypertension, or metabolic syndrome (all P < 0. 05) . The logistic regression analysis showed that metabolic syndrome, ALT, and ALT/AST ratio were independent risk factors for NAFLD (all P < 0. 05) , and metabolic syndrome, ALT, ALT/AST ratio, and GGT were independent risk factors for severe NAFLD (all P < 0. 05) . Conclusion ALT/AST ratio is an independent risk factor for NAFLD in CHC patients and has a certain value in evaluating the degree of NAFLD.
- hepatitis C, chronic /
- fatty liver /
- alanine transaminase /
- aspartate aminotransferases

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