NAFLD患者TE成像特点与其病情严重程度及胰岛素抵抗的关系研究

Study on the Relationship between the Characteristics of TE Imaging, Severity and Insulin Resistance in Patients with NAFLD

本研究旨在分析NAFLD(非酒精性脂肪性肝病)患者TE(瞬时弹性成像技术)成像特点与其病情严重程度及胰岛素抵抗的关系。通过选择我院NAFLD患者112例,健康体检的患者108例,对比两组患者基线资料,将NAFLD患者根据病情分组并对比相关资料。研究表明NAFLD组患者肝功能、血清胰岛素、HOMA-IR(胰岛素抵抗指数)显著高于对照组,差异显著(P<0.05)。随着脂肪肝严重程度增加,患者普遍年龄增高,男性多于女性,肝脏硬度、肝功能、胰岛素相关指标均明显上升,差异显著(P<0.05)。ROC曲线分析表明CAP(受控衰减参数)对轻度、中度和重度NAFLD均有较高的诊断价值,灵敏度分别为0.865、0.861、0.931,特异度分别为0.614、0.819、0.822。随着NAFLD病情严重程度的加重,CAP与HOMA-IR值均升高,呈显著正相关(r=0.536,r=0.479)。据此可推断NAFLD患者的TE成像特点与不同程度NAFLD密切相关,胰岛素抵抗可临床辅助诊断NAFLD。

The purpose of this study is to analyze the relationship between the imaging characteristics of TE(transient elastography)in patients with NAFLD(non-alcoholic fatty liver disease)and their severity and insulin resistance.We chose 112 patients with NAFLD and 108 patients with health check-up,compared the baseline data of the two groups of patients,and grouped the patients with NAFLD according to the condition and compared the relevant data.Research shows that the liver function,serum insulin,HOMA-IR(insulin resistance index)were significantly higher in the NAFLD group than in the control group(P<0.05).With the increase of fatty liver severity,the general age of patients increased,more men than women,liver hardness,liver function,and insulin-related indicators all increased significantly,with significant differences(P<0.05).The ROC curve analysis showed that CAP(controlled attenuation parameter)had high diagnostic value for mild,moderate and severe NAFLD,with sensitivity of 0.865,0.861,0.931,and specificity of 0.614,0.819,and 0.822,respectively.With the aggravation of severity’s condition in NAFLD,the CAP and HOMA-IR values increased significantly and were positively correlated(r=0.536,r=0.479).The TE imaging of NAFLD patients is closely related to the severity of NAFLD.Insulin resistance can also be clinically assisted in the diagnosis of NAFLD.