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目的探讨非酒精性脂肪肝(NAFLD)与高血压病发病的关系、可能机制及ALT在其中的可能作用和意义。方法观察组为NAFLD的患者125例;正常对照组105例。观察组分为二个亚组:A组(ALT大于40IU/L)60例;B组(ALT小于40IU/L)65例。测定各组空腹血糖(GLU)、血尿酸(UA)、血脂、C反应蛋白(CRP)、血清丙氨酸氨基转移酶(ALT),检测颈动脉内膜中层厚度(IMT)。结果①观察组高血压病发病率、血清空腹GLU水平、尿酸、CRP、TC、TG、LDL-C、IMT水平明显高于正常对照组,HDL-C水平低于正常对照组,差异有统计学意义(P<0.05);A组与B组相比,血尿酸水平、IMT高于B组,差别有统计学意义(P<0.01);空腹GLU、TC、TG、LDL-C、ApoB水平有增高趋势,HDL-C、ApoA1水平、ApoA1/ApoB值相比有所下降,但差异无统计学意义(P>0.05)。②ALT水平与患者血压值(收缩压及舒张压)呈正相关(r=0.419;0.381、P<0.05)。结论①NAFLD是高血压发病的易患因素。②NAFLD患者中ALT水平与高血压病严重程度有关。③NAFLD促进高血压病发生的可能机制与血管内皮功能失调、血管平滑肌增生、胰岛素抵抗等因素有关。
Objective To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) and the pathogenesis of hypertension and the possible mechanism and the possible role and significance of ALT in it. Methods 125 cases of NAFLD were observed in the observation group and 105 cases in the normal control group. The observation group consisted of two subgroups: 60 cases in group A (ALT greater than 40 IU / L) and 65 cases in group B (ALT less than 40 IU / L). The fasting blood glucose (GLU), blood uric acid (UA), blood lipids, C-reactive protein (CRP), serum alanine aminotransferase (ALT) and carotid intima-media thickness (IMT) were measured in each group. Results ① The incidence of hypertension, fasting serum GLU level, uric acid, CRP, TC, TG, LDL-C and IMT levels in observation group were significantly higher than those in control group and HDL-C levels were lower than those in normal control group (P <0.05). Compared with group B, serum uric acid level and IMT in group A were significantly higher than those in group B (P <0.01). The levels of GLU, TC, TG, LDL-C and ApoB The levels of HDL-C, ApoA1 and ApoA1 / ApoB decreased, but the difference was not statistically significant (P> 0.05). The level of ALT was positively correlated with the blood pressure (systolic pressure and diastolic pressure) of patients (r = 0.419; 0.381, P <0.05). Conclusion ①NFLD is a predisposing factor for the development of hypertension. The level of ALT in patients with NAFLD is related to the severity of hypertension. ③ The possible mechanism of NAFLD promoting hypertension is related to endothelial dysfunction, vascular smooth muscle proliferation, insulin resistance and other factors.