2型糖尿病伴脂肪肝患者的胰腺超声特征及相关因素分析

Ultrasound characteristics of pancreas of type 2 diabetic patients with fatty liver and its related factors

目的研究糖代谢异常包括2型糖尿病患者的胰腺大小及回声的特征，并探讨其影响因素。方法收集南京鼓楼医院糖代谢正常、糖调节受损、新诊断2型糖尿病及已诊断2型糖尿病患者157例。用直方图方法定量测量肝、肾、胰腺感兴趣区平均灰阶强度，并计算肝肾回声比值、肝脏衰减系数，根据公式推算肝脏脂肪含量。超声测量胰腺头、体、尾部大小，三者相加作为胰腺大小指标。将胰腺大小、回声强度进行单因素和多因素回归分析。结果胰腺大小为2．39-6．09em，平均（4．43±0．59）em，≤5cm的130例，〉5em的27例。胰腺回声41．0～190．6，平均回声120．0±31．1，≤120的83例，〉120的74例。肝脂肪含量-1．11％-62．50％，平均（15．67±11．97）％。单因素分析显示，胰腺大小与年龄大小、肥胖程度相关；胰腺回声强度与肥胖程度、入组受试者类型、血糖控制水平、脂肪肝严重程度分级相关（P值均〈0．05）。多因素分析显示肥胖程度是预测胰腺大小和回声强度最重要的影响因素（P值均〈0．05）。结论超声定量测量胰腺大小和回声可以反映胰腺脂肪浸润的程度，有一定的临床应用价值。

Objective To investigate the pancreas size and echo characteristics of patients with glucose metabolism disorders including type 2 diabetes, and to study its related factors. Methods One hundred and fifty-seven patients from Nanjing Drum Tower Hospital with normal glucose metabolism, impaired glucose regulation, newly diagnosed type 2 diabetes and established type 2 diabetes were collected. The average gray scale intensity of the liver, kidney, pancreas region of interest was measured by using the histogram method. Then the liver and kidney echo ratio, liver attenuation coefficient was calculated, and the fat content of liver was determined by using formula. The size of pancreas head, body and tail was detected by ultrasound, and the sum of three values was used as the pancreas size indicator. Univariate and multivariate logistic regression analysis was performed on the size of pancreas and intensity of echo. Results The size of pancreas ranged from 2.39 -6.09 cm with a mean size of （4.43 ± 0.59）cm, and the size was ≤5 em in 130 patients, 〉5 cmin 27 patients. The intensity of echo ranged from 41.0- 190.6 with a mean number of 120.0 ± 31.1, and the intensity of echo was ≤ 120 in 83 patients, 〉 120 in 74 patients. The content of liver fat ranged from -1.11%- 62.50% with a mean number of （15.67±11.97）%. Univariate logistic regression analysis suggested the size of pancreas was related to age and obesity, and pancreas echo was relatedto obesity degree, types of participants, Ihe level of blood glucose, and grade of fhtty liver （ all P 〈 0. 05 ）. Multivariate logistic regression analysis indicated obesity degree is the most important faetor for prediction of pancreas size and echo （P 〈0.05）. Conclusions Quantitative uhrasound measurement of pancreas size and echo can reflect the degree of fat infihration of pancreas, and it has some clinical value.