CAP对儿童非酒精性脂肪性肝病的诊断价值研究

Diagnostic Value of CAP in Children with Nonalcoholic Fatty Liver Disease

【目的】探讨CAP对儿童非酒精性脂肪性肝病(NAFLD)的临床诊断价值。【方法】选择2016年8月至2020年9月本院肝病中心收治的91例NAFLD患儿,均经肝脏组织活检,同时进行受控衰减参数(CAP)检查。另选取30例其他肝病患儿为对照组,经肝活检证实无肝脂肪变性,同时也进行CAP检测。运用儿童NAFLD组织学评分系统对肝脂肪变性进行分级,并进行相关性分析。【结果】观察组患儿BMI、门冬氨酸转移酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转移酶(GGT)、CAP、总胆固醇(TC)、三酰甘油(TG)均大于对照组,差异有统计学意义(P<0.05)。CAP区分有无肝脂肪变性的AUC为0.955,最佳截断值为222.5dB/m,95%CI为0.91~1.00,为94.5%、特异性为86.7%,按最佳截断值评估观察组肝脂肪变性准确率为94.51%(86/91)。BMI与CAP具有显著相关性(r=0.241,P=0.021<0.05)。【结论】CAP对儿童NAFLD的诊断有较高的临床价值,值得临床推广应用。

【Objective】To evaluate the clinical diagnostic value of CAP in children with NAFLD fatty liver.【Methods】From August 2016 to September 2020,91 children with NAFLD were selected from the liver disease center of our hospital.All patients underwent liver biopsy and controlled attenuation parameter(CAP)examination.Another 30 children with other liver diseases were selected as the control group.No hepatic steatosis was confirmed by liver biopsy,and cap was also detected.NAFLD histological scoring system was used to grade hepatic steatosis,and correlation analysis was performed.【Results】The BMI,AST,ALT,GGT,CAP,TC and TG of the observation group were higher than those of the control group(P<0.05).The AUC of cap was 0.955,the best cut-off value was 222.5 dB/m,the 95%CI was 0.91-1.00,which was 94.5%,and the specificity was 86.7%.According to the best cut-off value,the accuracy of liver steatosis in the observation group was 94.51%(86/91).BMI was significantly correlated with CAP(r=0.241,P=0.021<0.05).【Conclusion】Cap has high clinical value in the diagnosis of NAFLD in children,which is worthy of clinical application.