瞬时弹性成像技术对非酒精性脂肪性肝病的诊断及相关因素分析

Transient elastography in diagnosis of non-alcoholic fatty liver disease

回顾性分析2015年1月至2017年1月113例在泰州市人民医院住院诊治、肝活检病理检查诊断为非酒精性脂肪性肝病（NAFLD）患者的临床资料。肝病理检肝细胞脂肪变评分1分组（27例）、2分组（28例）、3分组（18例）和0分组（40例）间AST、血糖、TC、瞬时弹性成像技术检测的脂肪衰减参数（FAI）差异有统计学意义（均P〈0.01），0分组与1分组TC水平差异有统计学意义（P〈0.05），与2分组的血糖、FAI、BMI、TC水平差异有统计学意义（均P〈0.01），与3分组的AST、TG 、TC、BMI、血糖和FAI水平差异均有统计学意义（均P〈0.01）。FAI、BMI、TC与肝细胞脂肪变相关（r值分别为0.49、0.29、0.48，均P〈0.01）；受试者工作特征（ROC）曲线分析显示，FAI对各阶段脂肪肝体现很好的预测，诊断肝细胞脂肪变积分1、2、3分者的ROC曲线下面积值分别为0.78、0.90和0.96；logistics逐步回归分析示，TG、TC、BMI与FAI相关。

Clinical data of 113 patients with non-alcoholic fat liver disease （NAFLD） diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People′s Hospital were retrospectively reviewed. Patients all underwent transient elastographic （TE） examination and the values of fat attenuation index （FAI） were obtained. The hepatocyt fatty changes in pathological examination were scored as 0 （〈5%, n=40）, 1 （5%-33%, n=27）, 2 （34%-66%, n=28） and 3 （〉66%, n=18）. There were significant differences in AST, Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease. The areas under the ROC curve （AUCs） of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively. Logistic regression analysis showed that FAI was correlated with TG, TC and BMI. The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.