非酒精性脂肪性肝硬化的危险因素分析

肝脏 ›› 2026, Vol. 31 ›› Issue (4): 490-493.

非酒精性脂肪性肝硬化的危险因素分析

江丽萍, 王洪燕

350001 福州福州市鼓楼区鼓西街道社区卫生服务中心(鼓楼区总医院鼓西分院)全科(江丽萍);
350001 福州福建医科大学孟超肝胆医院心内科(王洪燕)

收稿日期:2025-05-13 出版日期:2026-04-30 发布日期:2026-06-04
通讯作者: 王洪燕,Email:546777543@qq.com

An analysis on the risk factors of nonalcoholic steatohepatitis-related cirrhosis

JIANG Li-ping¹, WANG Hong-yan²

1. Department of General Medicine, Gu Lou District Gu Xi Subdistrict Community Health Service Center, Fuzhou 350001, China;
2. Department of Cardiology, the Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350001, China

Received:2025-05-13 Online:2026-04-30 Published:2026-06-04
Contact: WANG Hong-yan, Email:546777543@qq.com

摘要/Abstract

摘要： 目的探讨非酒精性脂肪性肝硬化(NASLC)的影响因素,以早期预防非酒精性脂肪性肝炎(NASH)进展为NASLC。方法选取2017年12月至2019年12月在福建医科大学孟超肝胆医院住院的45例NASLC患者作为病例组,同时选取同期在该医院住院的180例NASH但未发展成肝硬化的患者作为对照组,分析NASLC的危险因素。结果病例组相关指标为:PT(13.98±3.88)s、PT-INR 1.01(0.92,1.10)、TT(17.57±1.57)s、TBil为17.5(9.4,26.5) μmol/L,均高于对照组,PT(12.91 ± 2.16)s、PT-INR 0.95(0.88,1.03)、TT(16.99±1.69)s、TBil 14.1(6.3,21.0) μmol/L。病例组PTA(95.6±18.78)％、UA( 286.84±84.77)μmol/L、TG 1.54(0.95,2.20) mmol/L、WBC(5.56±2.12)×10⁹/L、 PLT (167.71±70.24)×10⁹/L,均低于对照组PTA(105.78±15.17)％、UA(342.57±108.37)μmol/L、TG 1.91(1.20,2.7) mmol/L、WBC( 6.97±3.87)×10⁹/L及PLT (232.06 ±81.61)×10⁹/L,差异均具有统计学意义(均P＜0.05)。Logistic回归分析结果表明:对NASLC具有统计学意义的影响因素为UA(OR=0.994,95%CI:0.990～0.998)、PLT(OR=0.989,95%CI:0.984～0.994)。结论 UA下降、PLT减少是NASLC的独立危险因素。

关键词: 非酒精性脂肪性肝炎, 非酒精性脂肪性肝硬化, 危险因素, 尿酸, 血小板

Abstract: Objective To investigate the influencing factors of nonalcoholic steatohepatitis (NASH) progression to cirrhosis in order to prevent the development of NASH-related cirrhosis (NASLC) at an early stage. Methods A case-control study was conducted in patients enrolled from Mengchao Hepatobiliary Hospital of Fujian Medical University between December 2017 and December 2019. Within them, 45 hospitalized patients with NASH-related cirrhosis were selected as the case group, and 180 age- and sex-matched NASH patients without cirrhosis that were admitted during the same period of time was selected as the control group. The study aimed to analyze the risk factors associated with NASLC. Results In the case group, the levels of prothrombin time (PT), prothrombin time and international normalised ratio (PT-INR), thrombin time (TT), and total bilirubin (TBil) were (13.98±3.88)s, 1.01(0.92,1.10), (17.57±1.57)s, and 17.5(9.4,26.5)μmol/L, respectively, which were significantly higher than those of (12.91±2.16)s, 0.95(0.88,1.03), (16.99±1.69)s and 14.1(6.3,21.0)μmol/L in the control group. Conversely, the prothrombin time activity (PTA), uric acid (UA), total glycerol (TG) platelet count (PLT) and white blood cells count (WBC) in the case group were (95.62±18.78)% (286.84±84.77)μmol/L, 1.54(0.95,2.20)mmol/L, (5.56±2.12)×10⁹/L, and (167.71±70.24)×10⁹/L, respectively, which were significantly lower than those of (105.78 ± 15.17)%, (342.57 ± 108.37) μmol/L, 1.91(1.20,2.7) mmol/L, (6.97±3.87)× 10⁹/L, and (232.06±81.61)×10⁹/L in the control group (all P<0.05). By multifactorial logistic regression analysis it was revealed that the variables associated with NASH-related cirrhosis risk with statistical significance were UA (OR=0.994, 95% CI: 0.990~0.998) and PLT (OR=0.989, 95%CI: 0.984~0.994). Conclusion Decreased UA and PLT are independent risk factors for NASLC.

Key words: Non-alcoholic steatohepatitis, Non-alcoholic steatohepatitis-related cirrhosis, Risk factors, UA, PLT

江丽萍, 王洪燕. 非酒精性脂肪性肝硬化的危险因素分析[J]. 肝脏, 2026, 31(4): 490-493.

JIANG Li-ping, WANG Hong-yan. An analysis on the risk factors of nonalcoholic steatohepatitis-related cirrhosis[J]. Chinese Hepatolgy, 2026, 31(4): 490-493.

/ 推荐

参考文献

[1] Stasi C, Silvestri C, Voller F, et al. Epidemiology of liver cirrhosis[J]. J Clin Exp Hepatol, 2015,5(3):272.
[2] Wree A, Broderick L, Canbay A, et al. From NAFLD to NASH to cirrhosis-new insights into disease mechanisms[J]. Nat Rev Gastroenterol Hepatol, 2013,10(11):627-636.
[3] Habibullah M, Jemmieh K, Ouda A, et al. Metabolic-associated fatty liver disease: a selective review of pathogenesis, diagnostic approaches, and therapeutic strategies[J]. Front Med (Lausanne), 2024,11:1291501.
[4] Younossi Z M, Koenig A B, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes[J]. Hepatology, 2016,64(1):73-84.
[5] Angulo P. Long-term mortality in nonalcoholic fatty liver disease: is liver histology of any prognostic significance?[J]. Hepatology, 2010,51(2):373-375.
[6] Siddiqui M S, Fuchs M, Idowu M O, et al. Severity of nonalcoholic fatty liver disease and progression to cirrhosis are associated with atherogenic lipoprotein profile[J]. Clin Gastroenterol Hepatol, 2015,13(5):1000-1008.e3.
[7] 丁玉平, 李海, 张文, 等. ALT升高的非酒精性脂肪性肝病的流行病学特征及其危险因素分析[J]. 临床肝胆病杂志, 2017, 33(12):2355-2360.
[8] 尤红, 王福生, 李太生, 等. 慢性乙型肝炎防治指南(2022年版)[J]. 传染病信息, 2023,36(1):1-17.
[9] 范建高. 中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J]. 中国医学前沿杂志(电子版), 2012,4(7):4-10.
[10] 陆东东, 吴金明, 谢敏, 等. 不同饮酒量对脂肪肝患者肝功能和糖代谢的影响[J]. 温州医科大学学报, 2018,48(1):38-41+45.
[11] Day C P. Natural history of NAFLD: remarkably benign in the absence of cirrhosis[J]. Gastroenterology, 2005,129(1):375-378.
[12] Sherif Z A, Saeed A, Ghavimi S, et al. Global epidemiology of nonalcoholic fatty liver disease and perspectives on US minority populations[J]. Dig Dis Sci, 2016,61(5):1214-1225.
[13] Starley B Q, Calcagno C J, Harrison S A. Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection[J]. Hepatology, 2010,51(5):1820-1832.
[14] 袁婧, 张连峰. 平均血小板体积联合FIB-4指数对非酒精性脂肪性肝硬化预后的评估价值[J]. 中国现代医生, 2022,60(9):38-42+46.
[15] 杨发, 冯燕霞, 马成虎. 肝硬化患者血小板参数、凝血功能及D-二聚体变化与Child-Pugh肝功能分级的关系[J]. 临床消化病杂志, 2016,28(6):376-378.
[16] 农远志. 肝硬化患者血小板参数、凝血功能及D-二聚体变化与Child-Pugh肝功能分级的关系[J]. 中国实验诊断学, 2017,21(10):1782-1784.
[17] Hamaguchi M, Kojima T, Takeda N, et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease[J]. Ann Intern Med, 2005,143(10):722-728.
[18] Decaux G. Uric acid level in cirrhosis[J]. J Clin Gastroenterol, 2000,30(4):446-447.
[19] 张代民, 崔庆, 许会彬, 等. 血清尿酸检测在肝硬化中的意义[J]. 临床肝胆病杂志, 2007,(4):266-267.
[20] 刘沁雨, 常越, 张青, 等. 血清尿酸对非酒精性脂肪性肝病进展期肝纤维化/肝硬化的诊断价值[J]. 中国肝脏病杂志(电子版), 2020,12(1):24-30.