合并糖尿病和脂肪变性肝硬化患者肝脏硬度的临床研究

The study of diabetes mellitus and steatosis and liver hardness test

目的探讨合并糖尿病和脂肪变性肝硬化患者肝脏硬度的变化情况,旨在为该类患者的临床诊治提供一定的科学依据。方法选自该院2015年2月至2017年2月收治的肝硬化患者85例作为研究组,其中合并糖尿病患者25例,合并脂肪变性31例,单纯肝硬化35例,合并糖尿病+脂肪变性6例。另选取同期该院健康体检者51例作为对照组。入组研究对象均采用Fibro Touch检测肝脏硬度(包括肝脏弹性和肝脏衰竭值)。比较研究组和对照组肝脏弹性和肝脏衰竭值变化,肝硬化合并糖尿病和未合并糖尿病肝脏弹性和肝脏衰竭值变化,肝硬化合并脂肪变性和未合并脂肪变性肝脏弹性和肝脏衰竭值。结果研究结果显示,研究组肝脏弹性[(10.37±2.45)kPa]和肝脏衰减值[(124.39±21.98)kPa]均高于对照组[(2.18±0.64)、(24.69±3.59)kPa],且差异有统计学意义(P<0.05);合并糖尿病+脂肪变性组肝脏弹性[(17.94±3.75)kPa]和脂肪衰减[(189.48±34.21)kPa]高于合并糖尿病[(13.24±2.78)、(143.29±27.84)kPa]、合并脂肪变性组[(13.71±3.09)、(147.33±25.46)kPa]、单纯肝硬化组[(5.94±1.21)、(78.42±9.72)kPa],且差异均有统计学意义(P<0.05)。结论肝硬化合并糖尿病和脂肪变性存在明显的肝脏硬度异常,且高于单纯肝硬化患者,具有重要临床研究意义。

Objective To investigate the clinical significance of diabetes mellitus,steatosis and liver stiffness,so as to provide a reference value for clinical practice.Methods 85 patients with cirrhosis from February 2015 to February 2017 in our hospital were selected as the study group,25 cases of diabetic patients,31 cases of fatty degeneration,35 cases of simple liver cirrhosis,and 6 cases of diabetes and fatty degeneration.In the same period,51 cases of healthy physical examination in the hospital were selected as the control group.The liver stiffness(including liver elasticity and liver failure values)was measured by Fibro and Touch in the study group.A comparative study of group and group of liver elasticity and liver failure value change control,liver cirrhosis and diabetes and patients with liver failure and liver stiffness variation,fatty degeneration of liver cirrhosis with and without fatty degeneration of liver elasticity and liver failure value.Results The results of the study showed that the liver elasticity of liver research group[(10.37±2.45)kPa]and liver attenuation value[(124.39±21.98)kPa]were higher than the control group[(2.18±0.64),(24.69±3.59)kPa],and the difference was statistically significant(P<0.05);diabetes mellitus±steatosis liver elasticity[(17.94±3.75)kPa]and fat attenuation of[(189.48±34.21)kPa]was higher than that of diabetes mellitus[(13.24±2.78)kPa]and[(143.29±27.84)kPa],with steatosis[(13.71±3.09)kPa]and[(147.33±25.46)kPa]cirrhosis group[(5.94±1.21)kPa]and[(78.42±9.72)kPa],and there was statistical difference(P<0.05).Conclusion Liver cirrhosis combined with diabetes and fatty degeneration has obvious liver hardness,and is higher than that of patients with liver cirrhosis,which has important clinical significance.