瞬时弹性成像在2型糖尿病合并非酒精性脂肪肝病中的应用研究

Identification of type 2 diabetes mellitus combined with nonalcoholic fatty liver disease based on ultrasonic transient elastography

目的评估肝脏瞬时弹性成像技术(transient elastography,TE)对2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的临床应用价值。方法回顾性分析2018年4月至2021年8月在杭州市西溪医院的T2DM病例共54例,按有无合并NAFLD分为NAFLD组36例和非NAFLD组18例,基于TE检查获得肝脏脂肪衰减值(controlled attenuation parameter,CAP)及硬度值(liver stiffness measurement,LSM),比较分析两组CAP和LSM与疾病的关系。结果CAP和谷丙转氨酶(alanine aminotransferase,ALT)是T2DM合并NAFLD发生的独立危险因素,其识别T2DM合并NAFLD的诊断效能分别为0.829和0.772,两者联合诊断效能为0.944。结论TE技术的CAP测定是识别T2DM合并NAFLD患者的有效方法,尤其联合谷丙转氨酶具有更高的诊断效能。

Objective To evaluate the clinical value of transient elastography(TE)in patients with type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods A total of 54 cases of T2DM in Hangzhou Xixi hospital from April 2018 to August 2021 were retrospectively analyzed.They were divided into 36 cases in NAFLD group and 18 cases in non NAFLD group.The liver fat controlled attenuation parameter(CAP)and liver stiffness measurement(LSM)were obtained based on TE examination.The relationship between CAP and LSM and disease was compared and analyzed between the two groups.Results CAP and alanine aminotransferase were independent risk factors for T2DM complicated with NAFLD.The diagnostic efficiency of T2DM complicated with NAFLD were 0.829 and 0.772 respectively,and the diagnostic efficiency of combined diagnosis was 0.944.Conclusion CAP determination of TE is an effective method to identify T2DM patients with NAFLD,especially combined with alanine aminotransferase has higher diagnostic efficiency.