空腹C肽、FIB-4联合LSM在NAFLD合并糖尿病患者肝纤维化中的评估价值

Fasting c-peptide,FIB 4 joint LSM in NAFLD patients with diabetes mellitus assessment value of liver fibrosis

目的探讨空腹C肽、FIB-4联合LSM在NAFLD合并糖尿病患者肝纤维化中的评估价值。方法选取2019年10月~2020年11月我院收治的120例NAFLD合并2型糖尿病患者为研究对象,根据肝纤维化评分(NFS)将89例NAFLD轻度肝纤维化(NFS<0.676)患者分为观察A组,将31例NAFLD重度肝纤维化(NFS>0.676)患者分为观察B组,并选取同期在我院治疗的单纯2型糖尿病患者60例作为对照组。比较3组患者的LSM值、空腹C肽水平和FIB-4指数,采用多因素logistic回归分析NAFLD合并2型糖尿病患者发生进展性肝纤维化的独立危险因素,并计算联合评估的诊断效能。结果3组患者在空腹C肽、LSM、FIB-4指数方面比较,观察B组的空腹C肽、LSM、FIB-4指数均明显高于观察A组和对照组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,空腹C肽、LSM、FIB-4指数是NAFLD合并2型糖尿病患者发生进展性肝纤维化的独立危险因素;空腹C肽、FIB-4、LSM联合检测NAFLD合并2型糖尿病肝纤维化的灵敏度为91.01%,均高于空腹C肽、LSM、FIB-4单项检测的77.52%、80.89%和78.65%(均P<0.05)。结论空腹C肽、FIB-4联合LSM检测在NAFLD合并2型糖尿病患者发生进展性肝纤维化中具有一定的诊断价值。

Objective To investigate the evaluation value of fasting c-peptide,FIB4 combined with LSM in hepatic fibrosis of NAFLD patients with diabetes mellitus.Methods A total of 120 patients with NAFLD complicated with type 2 diabetes admitted to our hospital from October 2019 to November 2020 were selected as the study subjects,and 89 patients with mild fibrosis of NAFLD(NFS<0.676)were divided into observation group A according to the liver fibrosis score(NFS).Thirty-one patients with severe hepatic fibrosis with NAFLD(NFS>0.676)were divided into observation group B,and 60 patients with simple type 2 diabetes treated in our hospital during the same period were selected as control group.The value of three groups were compared the LSM,fasting c-peptide level and FIB4 index,uses the multi-factor logistic regression analysis NAFLD merger in patients with type 2 diabetes independent risk factors for the development of advanced liver fibrosis,and calculate the joint assessment of diagnostic performance.Results Three groups of patients in the fasting c-peptide,LSM,FIB4 index comparison,observe fasting c-peptide in group B,the LSM,FIB 4 index were significantly higher than the observation group and control group,differences were statistically significant(P<0.05).Multivariable logistic regression analysis showed,fasting c-peptide,LSM,FIB 4 index is NAFLD merger in patients with type 2 diabetes independent risk factors for the development of advanced liver fibrosis;Fasting c-peptide,FIB 4 NAFLD combined with type 2 diabetes,the LSM united detection sensitivity of hepatic fibrosis was 91.01%,higher than fasting c-peptide,LSM,FIB 4 single detection were 77.52%,80.89%and 78.65%(P<0.05).Conclusion Fasting c-peptide,FIB4 united LSM detection in NAFLD combination in advanced liver fibrosis in patients with type 2 diabetes has certain diagnostic value.