中枢神经系统是机体的重要调整体系,其自身的结构和功能具有随着内外环境变化而不断地修饰和重组的能力,被称为中枢神经系统的可塑性,学习和损伤修复的基础[1].但在出生后早期因脑出血致半球脑损伤对成年后运动与智力影响的报道甚少,现将1例诊断为婴儿期脑出血致右大脑半球囊化后中枢神经可塑性及功能重组现象报告如下.

[目的]探讨非肥胖者发生脂肪肝的危险因素及其临床特点.[方法]非肥胖脂肪肝发病危险因素的筛选采用Logistic回归分析方法,比较非肥胖与肥胖脂肪肝组间血脂、肝功能等生化指标的差异.[结果]嗜酒(OR:37.583),2型糖尿病(OR:5.731),TG(OR:5.007),LDL-C(OR:1.724)和空腹血糖(OR:1.618)与非肥胖脂肪肝的发病成正相关.非肥胖脂肪肝患者的LDL-C(62.1%)和UA(17.8%)升高及AST/ALT<1(48.5%)的发生率显著低于肥胖脂肪肝患者.[结论]嗜酒、2型糖尿病、高脂血症和空腹血糖升高是非肥胖患者发生脂肪肝独立的相关危险因素.非肥胖脂肪肝较肥胖脂肪肝有较小比例的血脂、尿酸异常改变和较少的AST/ALT<1的发生率.

目的探讨老年脂肪肝的独立危险因素及其临床特点.方法回顾性分析192例老年脂肪肝和221例非老年脂肪肝病人的临床资料,并随机抽取非脂肪肝的老年患者82例作为对照组.对老年脂肪肝组和对照组的血脂等变量进行回归分析,比较老年脂肪肝和非老年脂肪肝的临床特点和肝功能的改变.结果酗酒(OR=36.678)、体重指数(OR=20.795)、甘油三酯(OR=2.702)、2型糖尿病(OR=2.569)和空腹血糖(OR=1.836)与老年脂肪肝的形成有关.老年脂肪肝组高血压、冠心病的发生率高于非老年脂肪肝组,而肥胖、高脂血症、乙型与丙型肝炎病毒感染的比例显著低于非老年脂肪肝组.老年脂肪肝组ALT升高的比例(21.9%)显著低于非老年脂肪肝组(39.4%),A/G<1.5的比例(26.0%)高于非老年脂肪肝组(15.4%).结论酗酒、肥胖、高甘油三酯血症、2型糖尿病和空腹血糖升高为老年患者发生脂肪肝的独立危险因素.老年脂肪肝患者更易合并高血压和冠心病.老年脂肪肝患者的肝功能改变以慢性损害多见.

OBJECTIVE To analyze the associated risk factors, clinical characteristics and laboratory abnormalities of type 2 diabetes patients with fatty liver. METHODS The data of type 2 diabetes cases with fatty liver were collected in our hospital. 63 cases of type 2 diabetes without fatty liver were selected randomly as control during the same period. The associated variables were analyzed by using logistic regression model. The clinical data and liver function were compared between two groups. RESULTS The proportion of obesity and hyperlipidemia was higher in type 2 diabetes patients with fatty liver than without fatty liver. Body mass index (BMI) (OR: 4.392) was positive correlation to fatty liver in the patients with type 2 diabetes. In contrast, insulin sensitivity index (ISI) (OR: 0.000) and regular insulin treatment (OR: 0.058) were negative correlation to it. The abnormal frequencies of aspartate aminotransferase (AST, 16.0%), alanine aminotransferase (ALT, 25.2%), the ratio of AST/ALT less than 1 (52.8%) and gamma-glutamyltransferase (GGT, 31.9%) of type 2 diabetes patients with fatty liver were significantly higher than those without fatty liver (3.2%, 6.4%, 36.5% and 11.1% respectively). CONCLUSION Obesity and insulin resistance might increase the risk of fatty liver in the patients with type 2 diabetes. Patients of type 2 diabetes with fatty liver show higher serum lipid level and more obvious damages of liver function than those without fatty liver

目的:分析血脂正常者发生脂肪肝的危险因素及其]临床特征.方法:回顾性分析137例血脂正常的脂肪肝(血脂正常脂肪肝组)和137例血脂正常的非脂肪肝(对照组)病人的临床资料,对肥胖等相关因素进行Logistic回归分析,并比较血脂正常脂肪肝组和高脂血症脂肪肝组病人的临床特征、肝功能改变差异.结果:血脂正常患者发生脂肪肝的独立相关危险因素为嗜酒、肥胖、2型糖尿病、空腹血糖升高、高尿酸血症,其比数比(odds rate,0R)分别为27.49、26.95、3.14、1.60和1.00.血脂正常脂肪肝组患者的γ-谷氨酰转移酶(27.7%)和球蛋白(5.8%)升高及A/G异常(13.1%)的比例均显著低于高脂血症脂肪肝组,后者相应为38.8%、12.3%和23.9%,均为P＜0.05.结论:嗜酒、肥胖、2型糖尿病、空腹血糖升高和高尿酸血症是血脂正常者发生脂肪肝的独立相关危险因素.血脂正常脂肪肝组患者的肝功能损害较高脂血症脂肪肝组患者为轻.

[目的]比较酒精性脂肪肝和非酒精性脂肪肝的临床特点.[方法]收集28例酒精性脂肪肝和301例非酒精性脂肪肝的资料,并进行对比分析.[结果]酒精性脂肪肝组几乎均为男性,其肥胖((21.4%))、2型糖尿病(14.3%)、高脂血症(10.7%)和高血压的发病率(7.1%)显著低于非酒精性脂肪肝组(分别为59.5%、53.5%、64.1%和47.8%).酒精性脂肪肝组的血清甘油三酯(TG)、胆固醇(CHOL)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)和空腹血糖(FPG)的异常率低于非酒精性脂肪肝组,而高密度脂蛋白胆固醇(HDL-C)、天门冬氨酸氨基转移酶(AST)、AST/ALT(≥2)和直接胆红素(DB)的异常率则高于该组.[结论]酒精性脂肪肝好发于男性,肥胖、2型糖尿病、高脂血症和高血压的发生率显著低于非酒精性脂肪肝病人;其肝功能损害较非酒精性脂肪肝更明显.