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上海某社区65岁以上老年人脂肪肝的中医体质及相关因素分析

2021-11-04叶艳韦全华

上海医药 2021年20期
关键词:中医体质脂肪肝影响因素

叶艳 韦全华

摘 要 目的:分析上海某社區65岁以上老年人脂肪肝与高血压、糖尿病、血液生化指标和中医体质的关系。方法:研究对象为2020年5-8月在上海某社区卫生服务中心接受免费体检的1 043例65岁以上老年人,年龄65~96岁;其中女性559例,男性475例。通过调查问卷、腹部B超和实验室检查等方法,将老年人群分成脂肪肝组及非脂肪肝组,比较两组的血压、糖尿病、血液生化指标和中医体质等影响因素。结果:脂肪肝组中患高血压、糖尿病以及体重超重、肥胖、腹型肥胖、中心性肥胖的比率高于非脂肪肝组(P<0.05)。脂肪肝组的血清天门冬氨酸氨基转移酶(AST),血清丙氨酸氨基转移酶(ALT),三酰甘油(TG)和空腹血糖(FPG)指标均高于非脂肪肝组(P<0.05),而高密度脂蛋白胆固醇(HDL-C)则低于非脂肪肝组(P<0.05)。脂肪肝组患者中痰湿体质位居首位(12.1%),其次是气虚体质(11.6%),而非脂肪肝组中比例最高的是平和质,占31%,两组构成分布差异具有统计学意义(P<0.05)。logistic回归分析结果显示,体质量指数(BMI)、高血压、中心性肥胖、ALT、TG、HDL-C和部分体质类型是脂肪肝的影响因素(P<0.05)。结论:BMI升高、高血压、中心性肥胖、ALT、TG、部分体质类型是65岁以上老年人脂肪肝的危险因素,HDL-C是保护因素。

关键词 脂肪肝;老年人;中医体质;影响因素

中图分类号:R589.2 文献标志码:A 文章编号:1006-1533(2021)20-0058-05

基金项目:宝山区名中医传承工作室(BSMZYGZS-201905)

Analysis of TCM constitution and related factors of fatty liver in the elderly people over 65 years old in a community of Shanghai

YE Yan1, WEI Quanhua2(1.General Practice Department of Traditional Chinese Medicine of Qilian Community Health Service Center of Dachang Town of Baoshan District, Shanghai 200444, China; Department of Traditional Chinese Medicine of Wusong Hospital of Zhongshan Hospital Affiliated to Fudan University, Shanghai 200940, China)

ABSTRACT Objective: To analyze the relationship between fatty liver and hypertension, diabetes, blood biochemical indexes and constitution of traditional Chinese medicine(TCM) in the elderly people over 65 years old in a community of Shanghai. Methods: The research objects were 1 043 elderly people over 65 years old who underwent free physical examination in a community health service center in Shanghai from May to August 2020, and the age was from 65 to 96 years old; there were 559 females and 475 males. By means of questionnaire, abdominal B ultrasound and laboratory examination, the elderly people were divided into a fatty liver group and a non-fatty liver group, and the influencing factors of blood pressure, diabetes, blood biochemical parameters and TCM constitution were compared between the two groups. Results: The rates of hypertension, diabetes, overweight, obesity, abdominal obesity and central obesity in the fatty liver group were higher than those in the nonfatty liver group(P<0.05). The indexes of serum aspartate aminotransferase(AST), serum alanine aminotransferase(ALT), triacylglycerol(TG) and fasting blood glucose(FPG) in the fatty liver group were higher than those in the non fatty liver group(P<0.05), and high density lipoprotein cholesterol(HDL-C) in the fatty liver group was lower than that in non fatty liver group(P<0.05). In fatty liver group, phlegm dampness constitution ranked first(12.1%), followed by qi deficiency constitution(11.6%), the highest proportion of the non fatty liver group was pinghe quality, accounting for 31%, and there was significant difference in composition and distribution between the two groups(P<0.05). Logistic regression analysis showed that BMI, hypertension, central obesity, ALT, TG, HDL-C and some physical types were the influencing factors of fatty liver(P<0.05). Conclusion: increased BMI, hypertension, central obesity, ALT, TG and some physical types are the risk factors of fatty liver in the elderly over 65 years old, and HDL-C is the protective factor.

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