湿热内蕴型轻度脂肪肝CT定量测定与血脂的相关性研究

Relationship between CT quantitative and change of serum lipids in diffused mild fatty liver of syndrome of interior dampness-heat

目的:依据CT定量测定的结果,分析湿热内蕴型弥漫型轻度脂肪肝的肝脾CT值比值和血脂的变化,初步探讨两者在病程进展中的相关性。方法:60例门诊及住院患者经上腹部CT平扫及中医辨证分型,诊断为湿热内蕴型轻度脂肪肝;分别测量肝、脾CT值,计算肝脾CT值比值;同时检查血脂,包括总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)。将肝脾CT值的比值分为3个等级,即0.9～1.0(含1.0)、0.8～0.9(含0.9)、0.7～0.8(含0.8),常规统计学描述各等级肝脾CT值的比值及血脂(包括均数、标准差、标准误、95%CI和均数分布图),并进一步行组间方差分析(α=0.05)。结果:3个等级肝脾CT值的比值之间差异有统计学意义(P<0.01),3个等级的TC、TG值之间差异无统计学意义;第1等级与第2、3等级的HDL-C值之间差异有统计学意义(P=0.003,P=0.008,P<0.01),而第2、3等级之间差异无统计学意义(P=0.936)。结论:①CT定量测定较为准确地反映了肝内脂肪浸润的程度;②湿热内蕴型轻度脂肪肝的肝脾CT值比值在0.9以下时,血清HDL-C含量降低,间接提示肝内脂肪聚集有增加趋势,在临床治疗和随访中对此类患者应予以重视。

Objective： To explore the correlation of serum lipids and CT ratio of spleen-liver in the course of diffused mild fatty liver of syndrome of interior dampness-heat. Methods：Sixty cases verified clinically diffused mild fatty liver of syndrome of inte- rior dampness heat in our hospital accepted plain CT scan. The CT value of liver and spleen, serum lipids （included TC, TG, HDI. C） were measured respectively. The CT ratio of liver spleen was divided into three levels：0.9～1.0（include 1.0）,0.8～ 0.9（include 0.9） ,0.7～0.8（include 0.8）. The ratio of live-spleen and serum lipids of each level were conventional statistical described （includlng mean,standard deviation, standard error, means plot）, and then analyzed by ANOVA between levels（a= 0.05）. Results：It showed significant difference among the three levels of CT ratio of liver-spleen（ P 〈0.01）, while no significant differences were noted among three levels of TC and TG values. There was significant difference between level 1 and another two levels of HDL-C value（ P = 0. 003, P = 0. 008, P 〈0.01）, but no significant differences between level 2 and level 3 （P = 0. 936）. Conclusion..①CT quantitative determination can precisely reflect the degree of fatty liver. ②Serum HDL-C levels reduced when the CT ratio of liver-spleen was 0.9 or below, which suggest indireetly that there is an increasing trend of fat cells in liver steatosis,and sueh patients should be taken serious attention to in the elinieal treatment and follow-up.