声辐射力脉冲成像技术在2型糖尿病合并非酒精性脂肪肝病患者的应用

A pilot clinical study on quantitative evaluating the degree of diffuse fatty liver by acoustic radiation force impulse imaging in patients with T2DM complicated with NAFLD

目的:探索2型糖尿病(T2DM)合并非酒精性脂肪肝病(NAFLD)患者肝脏剪切波速度(VTQ值)的相关影响因素。方法:以227例T2DM合并NAFLD患者为研究对象,应用Siemens Acuson S2000彩色超声波诊断仪测量肝实质VTQ值,记录性别、年龄、病程,检测空腹血糖、糖化血红蛋白、甘油三脂、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、谷氨酰转肽酶、尿酸,分析T2DM合并NAFLD患者肝实质VTQ值与脂肪肝严重度和上述指标的相关性。结果:男、女的VTQ值差异具有显著性(P=0.000)。单因素线性分析,重度脂肪肝VTQ值显著高于轻、中度;肝实质VTQ值与和脂肪肝程度、Hb A1c、AST呈直线正相关,与年龄、糖尿病病程、INS、HDL-C呈直线负相关。结论:肝实质VTQ值对于T2DM合并NAFLD患者具有一定的评估价值。

Objective To investigate the influencing factors of the controlled virtual touch tissue quantification （VTQ） in liver of patients with type 2 diabetes mellitus （T2DM） complicated withnon-alcoholic fatty liver disease （NAFLD）. Methods Two hundred and twenty-seven patients with T2DM complicated with NAFLD were enrolled in this study,and the shear wave speed of the liver was measured by VTQ. Levels of the fasting plasma glucose, glycated hemoglobin,total cholesterol three acids glyceride, low density lipoprotein, high density lipoprotein , aspertate aminotransferase , alanine aminotransferase , gamma glutamyl transpeptidase and uric acid were measured. The relationships among VTQ and the severity of NAFLD , and those quantitative indexes were analyzed. Results Univariate analysis showed that the value of shear wave speed was negatively correlated with age,duration of diabetes,INS and HDL-C,while was positively correlated with HbA1c and AST. Conclusion Age, sex and levels of serum HbA1c,INS,AST and HLD-C might affect the values of shear wave speed in patients with T2DM complicated with NAFLD.