老年非酒精性脂肪性肝病患者100例的认知功能观察和临床特点

被引：10

作者：

许旌

杨立

师璇

王丹

杨帆

机构：

[1] 南京大学医学院附属鼓楼医院老年科

来源：

中华消化杂志 | 2019年 / 39卷 / 01期

关键词：

认知; 非酒精性脂肪性肝病; 可溶性转铁蛋白受体; 质子磁共振波谱;

D O I：

暂无

中图分类号：

R575.5 [肝代谢障碍];

学科分类号：

1002 ; 100201 ;

摘要：

目的观察老年非酒精性脂肪性肝病(NAFLD)患者认知功能、临床指标和海马组织结构的变化。方法纳入2014年12月至2016年6月在南京大学医学院附属鼓楼医院老年科住院的169例老年体检患者, 分成NAFLD组与非NAFLD组。收集两组患者的病史资料, 采用蒙特利尔认知评估量表(MoCA)进行认知功能障碍评估, 检测血清可溶性转铁蛋白受体(sTfR)水平, 进行肝脾比值测量和海马质子磁共振波谱(1H-MRS)检查。统计学方法采用t检验和线性回归分析。结果 169例老年患者中, NAFLD 100例, 非NAFLD 69例。NAFLD组患者的BMI和腰臀比分别为(25.9±3.4) kg/m2和1.03±0.13, 分别高于非NAFLD组的(24.2±3.7) kg/m2和0.95±0.06, 差异均有统计学意义(t=-2.714、-3.605, P均<0.01)。NAFLD组患者的MoCA评分为(20.1±5.8)分, 低于非NAFLD组的(22.1±4.4)分, 差异有统计学意义(t=2.154, P=0.033)。NAFLD组血清sTfR水平和肝脾CT比值分别为(8.78±4.31) mg/L和0.97±0.12, 分别低于非NAFLD组的(12.66±3.93) mg/L和1.19±0.15, 差异均有统计学意义(t=3.765、6.142, P均<0.01)。肝脾CT比值(β=7.597, 95%CI 2.938～12.935)、sTfR(β=0.552, 95%CI 0.304～0.787)与老年患者认知功能呈正相关(P均<0.01)。NAFLD组右侧海马高度为(0.410±0.074) mm, 低于非NAFLD组的(0.453±0.086) mm, 差异有统计学意义(t=2.078, P=0.042)。结论老年NAFLD患者认知功能减退, 这与铁负荷及肝脏脂肪密切相关。

引用

页码：35 / 39

页数：5

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