剪切波弹性成像定量检测与非酒精性脂肪肝病血清生物指标模型的相关性分析

Correlation analysis between quantitative detection of SWE and serum biological index model of NAFLD

目的:分析剪切波弹性成像(SWE)定量检测与非酒精性脂肪肝病(NAFLD)血清生物指标模型的相关性。方法:选取医院收治的40例NAFLD患者,将其纳入观察组,同期选取于医院查体中心查体的40名健康体检者纳入健康对照组。两组均采用实时剪切波弹性成像超长诊断仪进行SWE定量指标杨氏模量值检测,测量两组受检者肝前叶的弹性平均值。采集NAFLD患者入院24 h内的空腹静脉血,采集健康对照组查体时的空腹静脉血,采用全自动生化分析仪检测两组受检者总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)等脂代谢相关指标;采用多功能血糖仪检测两组受检者空腹血糖(FPG)、糖化血红蛋白(HbA1c)及胰岛素(FINS)水平。采用全自动生化分析仪检测两组受检者血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)水平。采用Pearson线性相关分析各因子水平变化的相关性。结果:两组患者的年龄、性别、体质量指数(BMI)水平等一般资料比较无统计学意义。观察组ALT、AST以及SWE定量指标杨氏模量值水平明显高于健康对照组(t=13.258,t=11.862,t=2.809;P<0.05),TC、TG、LDL-C、FPG、Hb A1C及FINS水平明显高于健康对照组,HDL-C水平明显低于健康对照组(t=6.820,t=4.347,t=5.765,t=4.338,t=16.856,t=9.102,t=7.712;P<0.05)。采用Pearson线性相关分析发现,SWE定量指标杨氏模量值与TC、TG、LDL-C、FPG、HbA1C、FINS、ALT及AST水平变化呈明显正相关(r=0.526,r=0.498,r=0.559,r=0.487,r=0.625,r=0.553,r=0.581,r=0.516;P<0.05),与HDL-C呈明显负相关(r=-0.473,P<0.05)。结论:SWE定量指标杨氏模量值与NAFLD患者血清糖代谢、脂代谢及肝功能指标模型存在一定相关性,可在评估NAFLD患者病情变化提供一定帮助。

Objective: To analyze the correlation between quantitative detection of shear wave elastography(SWE) and serum biological index model of nonalcoholic fatty liver disease(NAFLD). Methods: 40 patients with NAFLD who admitted to hospital were selected as the observation group, and 40 healthy persons who underwent physical examination in the physical examination center of hospital were selected as the health control group. Both two groups adopted real-time shear wave elastography super long diagnostic instrument to detect Young modulus value of SWE quantitative index, and the means of elasticities of hepatic anterior lobe of two groups were measured. The fasting venous blood of NAFLD patients within 24 hours after admission and the fasting venous blood of the control group during physical examination were respectively collected. The lipid metabolism related indexes included total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) and triglyceride(TG) were respectively detected by full automatic biochemical analyzer. The levels of serum fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c) and fasting insulin(FINS) of two groups were measured by multifunctional blood glucose meter. The levels of serum aspartate transaminase(AST) and alanine aminotransferase(ALT) were measured by full automatic biochemical analyzer. In addition, Pearson linear correlation was used to analyze the correlation among the changes of different factor levels. Results: There were no significant differences in age, gender and BMI between the two groups. The levels of ALT, AST and Young modulus value of SWE quantitative index in the observation group were significantly higher than those in the health control group(t=13.258, t=11.862, t=2.809,P<0.05). The levels of TC, TG, LDL-C, FPG, HbA1c and FINS in the observation group were significantly higher than those in the health control group, respectively, and the HDL-C level of former was significantly lower than that of the health control group(t=6.820, t=4.347, t=5.765, t=4.338, t=16.856, t=9.102, t=7.712, P<0.05). The results of Pearson linear correlation analysis showed that Young modulus of SWE quantitative index was significantly positive correlation with the levels of TC, TG, LDL-C, FPG, HbA1c, FINS, ALT and AST(r=0.526, r=0.498, r=0.559,r=0.487, r=0.625, r=0.553, r=0.581, r=0.516, P<0.05), respectively, and was negative correlation with HDL-C(r=-0.473, P<0.05). Conclusion: Young modulus value of SWE quantitative index has a certain of correlation with the index models of serum glucose metabolism, lipid metabolism and liver function of patients with NAFLD, which may provide a certain of help in assessing the changes of disease condition of patients with NAFLD.