目的 检测非酒精性脂肪性肝炎(NASH)患者血清中肝型脂肪酸结合蛋白(L-FABP)、肿瘤坏死因子-α(TNF-α)的水平,探讨二者在NASH发生及发展过程中的相关性及意义.方法 收集肝功能异常的NASH患者50例(NASH组),经B超检查符合弥漫性脂肪肝的诊断标准,对照组为健康体检者32例.所有受试者测量身高、体质量、腰围及臀围,并计算体质量指数(BMI)和腰臀比(WHR),晨起空腹抽取静脉血液检测L-FABP、TNF-α及相关临床指标.结果 NASH组患者的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、BMI、WHR、TNF-α、高敏C反应蛋白(hs-CRP)和L-FABP水平均显著高于对照组(P<0.05),Spearman相关分析提示,NASH组血清L-FABP水平与TNF-α、TC、LDL-C、ALT、血尿酸(UA)、hs-CRP呈正相关 (P<0.05),TNF-α水平与ALT、UA、hs-CRP显著正相关(P<0.05).结论 L-FABP和TNF-α可能在NASH患者肝功能损伤与炎症反应中发挥重要作用.%Objective To detect the level of serum liver-type fatty acid binding protein (L-FABP) and tumor necrosis factor-α (TNF-α),and to investigate its relationship with the occurrence and developing process of nonalcoholic steatopatitis (NASH) and significance .Methods 50 cases of NASH with abnormal liver function (NASH group) and 32 healthy person as the control group were collected .B-type ultrasonic inspection was performed in all the subjects to confirm the diagnosis of diffuse fatty liver .Height , weight ,waistline and hipline were measured and BMI and WHR were calculated .Morning fasting blood was collected for detecting the level of serum L-FABP ,TNF-α and related clinical indexes .Results Compared with the control group ,the levels of ALT ,AST , TC,LDL-C,TG,BMI,WHR,hs-CRP,L-FABP and TNF-α in the NASH group were increased significantly ( P<0.05).The Spearman correlation analysis revealed that the L-FABP level was positively correlated with TNF-α ,TC ,LDL-C ,ALT ,UA ,and hs-CRP (P<0 .05) ,and the TNF-α level was positively correlated with ALT ,UA ,and hs-CRP (P<0 .05) .Conclusion L-FABP and TNF-α may play the important role in the impaired liver function and inflammation in NASH .
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