APRI在大肠息肉合并非酒精性脂肪性肝病患者中的临床价值

Clinical value of APRI in patients with colorectal polyps complicated with non-alcoholic fatty liver disease

目的探究APRI在大肠息肉合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者中的临床价值。方法选择锦州市中心医院消化内科符合纳入标准的住院患者146例,根据息肉病理分为对照组(37例)、低危组(78例)及高危组(31例)。收集三组患者的一般资料进行方差分析及卡方检验,并采用多因素Logistic回归分析纳入患者的独立危险因素。对APRI与息肉大小进行Pearson相关性分析;建立ROC曲线,分析APRI在大肠息肉合并NAFLD患者中的临床价值。结果高危组的年龄、性别、吸烟史、BMI、TG、ALT、AST、UA及APRI高于对照组,PLT、HDL-C低于对照组,差异有统计学意义(P<0.05),其中年龄差异显著(P=0.000),男性构成比明显高于女性;对该疾病发生的影响因素有年龄(OR=1.226)、APRI(OR=1.215)、吸烟(OR=1.124)。大肠息肉直径与APRI呈正相关(r=0.39,P=0.000)。APRI在其风险评估中的AUC为0.822,最佳诊断点为0.235,其敏感度及特异度分别为96.1%和55.8%。结论 APRI在大肠息肉合并NAFLD患者中可以预测息肉发展为恶性肿瘤的风险,可作为临床判断预后的指标之一。

Objective To explore the clinical value of APRI in patients with colorectal polyps complicated with non-alcoholic fatty liver disease(NAFLD). Methods A total of 146 inpatients who underwent colonoscopy and met the inclusion criteria were included in the Department of Gastroenterology, Jinzhou Central Hospital. According to the polyp pathology, they were divided into control group(37 cases), low-risk group(78 cases) and the high-risk group(31 cases). General data were collected from 3 groups of patients, and multivariate Logistic regression was used to analyze independent risk factors for colorectal polyps with NAFLD. Pearson correlation analysis was performed on APRI and the diameter of polyp. ROC curve was established to analyze the clinical value of APRI in the patients. Results The age, gender, smoking history, BMI, TG, ALT, AST, UA and APRI in the high-risk group were higher than those in the control group, PLT and HDL-C in the high-risk group were lower than those in the control group(P<0.05). The difference of age was significant(P=0.000) and the male composition ratio was significantly higher than that of females. Age(OR=1.226), APRI(OR=1.215), smoking(OR=1.124) were the influence factors for the disease. The diameter of colorectal polyps was positively correlated with APRI(r=0.39, P=0.000). In its risk assessment, the best diagnostic point for APRI was 0.235. The sensitivity of APRI was 96.1% and the specificity was 55.8%. Conclusion APRI can predict the risk of developing polyps into malignant tumors in patients with colorectal polyps and NAFLD. It can be used as one of the indicators for clinical judgment of prognosis.