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Journal of the Korean Academy of Family Medicine 1995;16(11):785-794.
Published online November 1, 1995.
Causes of fatty liver diagnosed by abdominal ultrasonography.
Seong Hun kim, Dong Ho Kang, Sang Heun Lee, Chang Heon Yun
복부초음파로 진단된 지방간의 원인
김성훈, 강동호, 이상현, 윤창헌
Abstract
Background
: abdominal ultrasound test is commonly seen at the primary care unit by the family physician, the fatty liver is one of the most frepuent finding by its examination. Also the fatty liver is easily treated with the removal of offending agents, but there is few thesis about the causes of the fatty livers in our country. So the purpose of this study is to find the possible causes of the fatty livers.

Methods : 104 fatty liver cases(male 65, female 39) was selected from the total 1635 cases being diagnosed by the abdominal ultrasonography at the radiologic department of the Bucheon Daesung Hospital from Jily 1993 to June 1994 through the review of the patient's charts. And then fatty liver cases were classified according to Mittelstaedt's classification to group I(mild), group Ⅱ(moderate) and group Ⅲ(sever) and found out the causes of the fatty livers.

Results : The frequency of the fatty liver was about 6% of being the abdominal ultrasonographied patients and the average age of the subjects was 44.8 years olds. Distributions of the fatty liver groups were 61 cases(59%) as group I, 28 cases(27%) as group Ⅱ and 15 cases(15%) as group Ⅲ, respectively. There were oredrs in classifing the causes alcohol(21 subjects, 34%), obesity(21.34%), unknown(12.20%), Diabetes(4.7%), and others (3.5%) as group I, obesity(10.34%), alcohol(9%, 31%), diabetes(5.17%), unknown(4.14%) and drup(1.4%) as group Ⅱ, alcohol(4.27%), obesity(3.20%), others(4.26%), unknown(3.20%) and drung(1.6%) as group Ⅲ. There was an sequence in the whole classification of the causes of the fatty livers that was 35 subjects(32.7%) being alcohol and obesity, each other, 19 subjects(18.3%) being unknown cause, 9 subjects(8.7%) being diabetes, 6 subjects being others and 2 subjects(1.9%) being drug.

Conclusion : It was more important to treat the fatty liver properly with the causative correction of the offending agents than to confirm the fatty liver in the abdominal ultrasonography undoubtedly.
초록
연구배경 : 일차진료를 담당하는 가정의들이 외래에서 흔히 접할 수 있는 검사가 복부 초음파이며 지방간은 가장 흔한 소견중의 하나이다. 또한 진단된 지방간환자는 원인제거를 통해 쉽게 치유되는 질병이나 국내의 연구는 그렇게 많지 않아 저자들은 지방간환자들의 가능한 원인을 알아보고자 본연구를 실시하였다.

방법 : 1993년 7월 1일에서 1994년 6월 30일까지 부천 대성병원 방사선과에서 복부초음파 검사를 받은 1635명중 지방간으로 판독된 104명(남 65, 여 39)을 대상으로 의무기록을 검토하여 초음파상 Mittelstaede의 지방간 분류에 따라 Ⅰ군(경증),Ⅱ군(중등도) 및 Ⅲ군(중증)으로 대별하여 각각의 원인을 찾아보았다.

결과 : 전체 복부초음파 검사자중 지방간환자의 빈도는 약 6%이었으며 평균 연령은 44.8세였으며, 각군의 환자분포는 Ⅰ군은 61명(59%),Ⅱ군은 28명(27%), 및 Ⅲ군은 15명(15%)이었다. 원인별분류는 Ⅰ군은 알코올(61명,34%), 비만(21명,34%), 원인미상(12명,20%), 당뇨병(5명,17%), 원인미상(4명,14%) 및 약물(1명,4%)이었고, Ⅲ군 알코올(4명,27%), 비만(3명,20%), 기타(4명,27%), 원인미상(3명,20%) 및 약물(1명,6%)등의 순이였다. 전체적인 원인별 분류는 알코올과 비만이 각각 35명씩 (32.7%)이었고, 다음으로 원인미상 19명(18.3%), 당뇨병 9명(8.7%), 기타 6명(5.8%) 및 약물 2명(1.9%)이었다.

결론 : 초음파 검사를 통해 지방간의 진단을 내리는것도 물론 중요하지만 가능한 원인을 찾아 지방간을 치료하는 것이 더 바람직하리라 사료 된다.


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