摘要:目的 检测非酒精性脂肪肝（NAFLD）患者血清AFP水平，并探讨其应用价值。方法 对97例患者进行评估，患者通过做腹部超声诊断确定为脂肪肝,并分成3个组。无脂肪肝患者作为对照组。所有患者和对照组进行体格检查、肝功能检测、稳态模型法评估胰岛素抵抗指数(HOMA-IR)检测。结果 体格指数，AST、ALT、血糖、HOMA-IR等在NAFLD患者中高于对照组。TG、总胆固醇、LDL-C、HDL-C水平在NAFLD中高于对照组。AFP水平在NAFLD中比对照组显著升高（5.43±2.65 IU/mL vs 2.33±0.99 IU/mL, P<0.05）。三级NAFLD AFP水平显著高于一级NAFLD （6.70±2.36 IU/mL VS 3.56±1.20 IU/mL ,P<0.05）和二级NAFLD AFP水平（6.69±2.36 IU/mL VS 4.27±1.79 IU/mL,P<0.05）。另外，二级NAFLD AFP水平显著高于一级NAFLD（P<0.05）。ALT、AST与其无相关性。结论 NAFLD患者AFP水平高于非脂肪肝患者，AFP水平与脂肪病分级有关，NAFLD 分级与血清 AFP水平的相关性独立于其它因素。

Abstract: Objective To analyze the importance of AFP level in nonalcoholic fatty liver disease (NAFLD). Methods Degree of liver steatosis in 97 patients was graded into three groups. As a control group, patients without fatty liver or other liver diseases were included. All patients and controls were carried out a physical examination, biochemical analyses including liver function tests, the components of the metabolic syndrome, and the homeostasis model assessment to estimate insulin resistance (HOMA-IR) score were also performed. Results Body mass index, AST, ALT, glucose, insulin and HOMA-IR in patients with NAFLD were higher than that in control group. The TG, TC, LDL-C, and HDL-C levels in NAFLD group were higher than that in control. A statistically significant increase in AFP levels was noted in patients with NAFLD when compared with controls (5.43±2.65 IU/mL vs 2.33±0.99 IU/mL, P<0.05). A statistically significant increase in AFP levels was noted in patients with grade 3 NAFLD when compared with grade 1 (6.69±2.36 IU/mL vs 3.56±1.20 IU/mL, P<0.05) and grade 2 NAFLD groups (6.69 IU/mL±2.36 IU/mL vs 4.27±1.79 IU/mL, P<0.05). AFP in grade 2 NAFLD group was significantly higher than that in grade 1. AFP was correlated with NAFLD grade. According to multivariate analysis, the correlation between NAFLD grade and serum AFP levels was independent factors to NAFLD. Conclusion Patients with NAFLD have higher AFP levels than those with fatty liver changes. The AFP levels might be used to identify the grade of liver steatosis in patients with nonalcoholic fatty liver disease.