血脂测定在非酒精性肝脂肪变性诊断中的应用

The value of blood lipid parameters in nonalcoholic fatty liver disease

目的探讨血清脂质测定在非酒精性肝脏脂肪变性(NAFLD)诊断中的应用价值。方法测定169例NAFLD患者和123名健康者对照血清脂质、载脂蛋白水平,用受试者工作特征(ROC)曲线分析各参数的诊断价值。结果NAFLD患者的三酰甘油(TG)、载脂蛋白C3(apo C3)、载脂蛋白E(apo E)、apo C3/apo E、非高密度脂蛋白胆固醇(non-HDL-C)及胆碱酯酶(ChE)明显高于对照组(P<0.05),高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-Ⅰ(apo A-Ⅰ)明显低于对照组(P<0.05),ChE、apo C3、apo C3/apo E及apo C3/apo E+ChE+HDL-CROC曲线下的面积分别为0.603、0.654、0.743和0.760。结论apo C3/apo E比值及其与ChE和HDL-C联合检测可提高对NAFLD的诊断效率。

Objective To investigate the diagnostic value of blood lipid parameters in nonalcoholic fatty liver disease（NAFLD）. Methods The levelvs of lipid parameters of 169 patients with NAFLD and 123 healthy controls were determined. The diagnostic values of these parameters were evaluated by receiver operating characteristic（ROC） curve. Results The levels of triglycerides（TG）, apolipoprotein（apo）C3, apo E, apo C3/apo E, non high-density lipoproteins-cholesterol（non-HDL-C） and cholinesterase（ChE） in patients with NAFLD were higher than those in healthy control, but high-density lipoproteins-cholesterol（HDL-C） and apo A-I levels were significantly lower than those in healthy control. The area under ROC curve of ChE, apo C3 , apo C3/apo E and apo C3/apo E ＋ ChE＋HDL-C of patients with NAFLD were 0. 603,0.654, 0.743 and 0. 760 respectively. Conclusions The combined detection of apo C3, apo E, ChE and HDL-C can increase the diagnostic effectiveness for NAFLD.