非酒精性脂肪性肝病患者血清肝纤维化指标与肝内脂肪含量的相关性研究

Correlation between serum fibrosis markers and intrahepatic fat content in patients with nonalcoholic fatty liver disease

目的探讨非酒精性脂肪性肝病(NAFLD)患者肝纤维化指标与T1WI同/反相位测定肝内脂肪含量的关系。方法选取2017年6~8月非酒精性脂肪性肝病者120例,根据肝纤维化评分(NFS)将患者分为NFS<-1.455亚组(n=35, A组),-1.455≤NFS≤0.676亚组(n=41, B组)及NFS>0.676亚组(n=44, C组)。选择同期体检的年龄、性别、地域相匹配的健康人群50例为对照组,使用SPSS 19.0软件包对数据进行统计分析,肝纤维化指标和肝脏脂肪相对含量用(x^-±s)表示,两两比较采用t检验,多组间比较采用方差分析及Spearman相关分析。P<0.05表示差异有统计学意义。结果 C组随着血清肝纤维化指标CK18、 YKL40、 APRI、 GPRI的升高,肝内脂肪含量减低,呈负相关关系(r=-0.850、-0.584、-0.784、-0.684,P<0.05),A组及B组未发现相关关系(P>0.05)。结论非酒精性脂肪性肝炎有肝纤维化趋势,肝内脂肪含量与肝纤维化的进展密切相关。

Objective To investigate the relationship between the liver fibrosis indexes and liver fat content quantitatively detected by in-phase opposed-phase T1 WI sequences in patients with nonalcoholic fatty liver disease(NAFLD). Methods 120 patients with NAFLD from June to August 2017 were selected. According to the NAFLD fibrosis score(NFS), the patients were divided into NFS<-1.455 subgroup(n=35, group A),-1.455≤NFS≤0.676 subgroup(n=41, group B) and NFS>0.676 subgroup(n=44, group C). A total of 50 healthy subjects with matching age, gender and region were selected as the control group. Serum CK18 and YKL40 levels were detected by ELISA, and liver fat content was detected by in-phase opposed-phase T1 WI sequences. SPSS 19.0 statistical software was used for data analysis. Liver fibrosis indexes and liver fat relative content were showed as (x^-±s), compared with independent t test. Multiple date sets were compared with Variance and Spearman correlation analysis, P<0.05 indicated the difference was statistically significant. Results The values of CK18, YKL40, APRI and GPRI were increased significantly in C group patients, and negative correlation was found(r=-0.850,-0.584,-0.784 and-0.684, P<0.05). The relevance of values of CK18, YKL40, APRI and GPRI and liver fat content in group A and B was not found(P>0.05). Conclusion Liver fibrosis trend was found in nonalcoholic steatohepatitis patients,and the liver fat content is closely related to the progression of liver fibrosis.