目的 探讨苯作业非酒精性脂肪肝工人丙氨酸氨基转移酶(ALT)水平与颈动脉粥样硬化的关系。方法 190名的苯作业非酒精性脂肪肝工人分为ALT异常组(ALT≥40 U/L)及ALT正常组(ALT＜40 U/L)。ALT异常组再根据ALT水平分为依据ALT水平分为G1组(60例,40 U/L≤ALT＜60 U/L),G2组(40例,60 U/L≤ALT＜80 U/L),G3组(35例, ALT＞80 U/L)。观察各组颈部动脉有否内膜增厚或斑块形成。结果 与ALT异常组颈动脉内膜增厚检出率和颈动脉斑块检出率明高于ALT正常组(P<0.05)。颈动脉内膜增厚检出率和颈动脉斑块检出率与ALT正常组相比较,G1组差异无统计学意义(P＞0.05), G2组有统计学意义(P<0.05),G3组有差异(P<0.01)。颈动脉内膜增厚检出率在G1组、G2组和G3组中逐渐增加,并有统计学意义(P<0.05)。G3组颈动脉斑块检出率与G1组比较,有差异(P<0.01)。结论 苯作业非酒精性脂肪肝工人中,血清ALT水平升高与颈动脉粥样硬化密切相关。ALT≥60 U/L的苯作业非酒精性脂肪肝人群更容易患颈动脉粥样硬化,应进行必要的预防和治疗。

Objective To explore the relationship between serum alanine aminotransferase levels(ALT) and carotid atherosclerosis in benzene exposed workers with nonalcoholic fatty liver disease. Methods 190 Benzene exposed workers with nonalcoholic fatty liver disease were enrolled divided into abnormal ALT group(n=135) and normal ALT group(n=55), the abnormal ALT group was further divided into three groups according to the levels of serum alanine minotransferase (ALT): group1(G1,60 subjects, 40 U/L≤ALT＜60 U/L),group2(G2,40 subjects, 60 U/L≤ALT＜80 U/L),and group3(G3,35 subjects, ALT＞80 U/L),observed if carotid has only thick endomembrane or with plaques. Results The rate of thick endomembrane of carotid and the detection rate of plaque in the abnormal ALT group are higher than those in the normal ALT control group (P<0.05). Compared with the normal ALT control group, no significant different was found in the rate of thick endomembrane of carotid and the detection rate of plaque in G1,but G2 was significantly different(P<0.05),G3 was extremely significantly different(P<0.01). The rate of thick endomembrane of carotid in G1,G2 and G3 increased, among the three groups. There were statistically significant differences in the rate of thick endomembrane of carotid(P<0.05). benzene exposed workers with nonalcoholic fatty liver disease in G3 showed extremely statistical differences on the detection rate of plaque compared to those in G1(P <0.01). Conclusion The increased level of ALT in benzene exposed workers with nonalcoholic fatty liver disease is closely related to carotid atherosclerosis. The benzene exposed workers with nonalcoholic fatty liver disease whose ALT≥60 U/L are apt to carotid atherosclerosis, should accept the necessary precaution and treatment.