不同中医证型非酒精性脂肪性肝病患者的CT影像学特征分析

Analysis of CT imaging features of patients with NAFLD of different TCM syndromes

目的:探究非酒精性脂肪性肝病(NAFLD)患者中医证型与CT值、实验室指标的关系。方法:于2021年1月至2021年10月在北京某三甲医院体检中心招募NAFLD患者129例,按照制定的标准化问卷调查表和体检报告收集人口学信息和实验室指标,并进行中医证型分析。结果:共纳入NAFLD患者129例,平均年龄(46.2±9.5)岁。在4种证型中,湿热蕴结证(52.71%)最为常见,其余依次为痰瘀互结证(28.68%)、肝郁脾虚证(10.08%)和痰浊内阻证(8.53%)。痰瘀互结证患者肝脏CT值[39.1(33.0,41.5)]显著低于湿热蕴结患者[44.1(34.6,46.4)]和痰浊内阻证患者[47.4(37.8,50.4)],均P<0.05。痰瘀互结证患者肝脾CT比值[0.72(0.60,0.79)]显著低于肝郁脾虚证患者[0.80(0.76,0.89)]、湿热蕴结证患者[0.81(0.67,0.88)]和痰浊内阻证患者[0.86(0.72,0.88)],均P<0.05。不同中医证型NAFLD患者的PLT、Urea、HDL-C水平存在统计学差异。结论:NAFLD患者以湿热蕴结证最为常见;与其他证型患者相比,痰瘀互结证患者脂肪变性程度更重。将中医证型与CT值和实验室指标相结合,有助于从中西医结合的角度更全面的认识NAFLD。

Objective:To explore the association between traditional Chinese medicine(TCM)of syndromes,CT values,and laboratory parameters in patients with NAFLD.Methods:A total of 129 patients with NAFLD was recruited from January 2021 to October 2021 at a tertiary care hospital physical examination center in Beijing,and demographic information and laboratory parameters were collected according to the standardized questionnaire and physical examination reports,and TCM syndrome was analysed.Results:A total of 129 patients with NAFLD was included,with an average age of(46.2±9.5)years.Among the four types of TCM syndrome,the dampness-heat syndrome(52.71%)was the most common,followed by intermingled phlegm and blood stasis syndrome(28.68%),liver-stagnation and spleen-deficiency syndrome(10.08%),and phlegm syndrome(8.53%).The liver CT values in patients with intermingled phlegm and blood stasis syndrome[39.1(33.0,41.5)]were significantly lower than those in patients with dampness-heat syndrome[44.1(34.6,46.4)]and those with phlegm syndrome[47.4(37.8,50.4)],with P values<0.05.The CT ratio of the liver and spleen in patients with intermingled phlegm and blood stasis syndrome[0.72(0.60,0.79)]was significantly lower than that in patients with liver-stagnation and spleen-deficiency syndrome[0.80(0.76,0.89)],and those with dampness-heat syndrome[0.81(0.67,0.88)]or phlegm syndrome[0.86(0.72,0.88)],with P values<0.05.There were statistical differences in PLT,Urea,and HDL-C levels in NAFLD patients with different TCM syndromes.Conclusion:Dampness-heat syndrome was most common in patients with NAFLD;compared with patients with other TCM syndromes,patients with intermingled phlegm and blood stasis syndrome had more severe steatosis.The combination of TCM syndrome,CT values,and laboratory parameters can help to understand NAFLD more comprehensively from the perspective of traditional Chinese medicine and Western medicine.