三酰甘油在非酒精性脂肪肝中的诊断价值及其与丙氨酸氨基移换酶的关系  

Diagnostic significance of blood triglyceride to non-aleoholic fatty liver by ROC curve

作　　者：石柯[1] 王一任[2] 袁伟建[3] 

机构地区：[1]中南大学湘雅医院干部医疗科,湖南长沙410008 [2]中南大学公共卫生学院卫生统计学教研室,湖南长沙410078 [3]中南大学湘雅医院消化内科,湖南长沙410008

出　　处：《中国现代医学杂志》2006年第12期1885-1887,共3页China Journal of Modern Medicine

摘　　要：目的用ROC曲线(ReceiverOperatingCharacteristicCurve)评价血三酰甘油(triglyceride,TG)对非酒精性脂肪肝(non-alcoholicfattyliver,NAFL)诊断意义及丙氨酸氨基移换酶(Alanineaminotransferase,ALT)与三酰甘油的关系。方法通过B超和临床体格检查,血清甲、乙、丙型肝炎病毒标志物均为阴性,血液葡萄糖在正常参考范围内,无饮酒嗜好的门诊健康体检人员217人,其中男122人,女95人。将以上人员按TG分为3组:第1组(血ALT正常)80人,其中男45人,女35人;第2组(血ALT增高)53人,其中男35人,女18人(第1、2组经诊断为非酒精性脂肪肝)。第3组为正常对照组(ALT和TG均在正常范围)未发现脂肪肝,共84人,其中男42人,女42人。结果第1、2组ROC曲线的面积(areaunderthecurve,AUC)分别为0.907和0.917,非常接近,第1、2组合并总数的AUC为0.911。第1组与第2组TG值差异无显著性(t=0.650P=0.517);第1、2组TG值与第3组比较差异均有显著性(t分别为8.118、10.420,均P<0.005)。第1、2组男女NAFL增高例数经校正χ2检验差异均有显著性(第1组χ2=0.423,0.75>P>0.5;第2组χ2=0.00328,P>0.9)。第1、2两组男女TG增高总例数差异亦无显著性(0.9>P>0.75)。第2组ALT和TG无相关关系。r=0.0402,P>0.25。结论经ROC曲线分析TG对NAFL很有协助诊断价值;ALT与TG为单独预报因子,无相关关系;男女TG水平增高例数统计学上无差别。[Objective] To evaluate diagnostic significance of blood triglyeeride to non-alcoholic fatty liver （NAFL） and relation between ALT and triglycerides by ROC Curve （Receiver Operating Characteristic Curve） [Method] 217 adults（men 122, women 95） with 22-55 y. mean 48.2 y were physically examined at out-patient department of this hospitol. They were diagnosed by ultrasonography. They had no history of alcohol abuse and negative tests of hepatatis A, B and C virus serum marks and blood glucose were in normal range. According to TG, all the 217 case were divided into 3 groups. The first group （ALT normal） was 80 （men 45, women 35）, the second group 53 （mem 35, women 18）, and the third group 84 （men 42, women 42）. Groups 1 and 2 were diagnosed NAFL, and the group 3 was contral one with no NAFL and normal of ALT and TG. [Result] ROC Curve＇s AUC of groups 1 and 2 was respetively 0.907 and 0.917,very approachly. The sum of 1 and 2 group was 0.911. The TG concentration （mmol/L） was not distinctive between group 1 and 2 （P=0.517）. There was significant difference between group 1, 2 and 3. （P 〈0.005）. The NAFL persons of men and women were not distinctive by correct X^2 tests （P 〉0.5）. There is no correlation by eorrmetation coefficient test between blood ALT and TG concentration of group 2. [Conclusion] TG leverl analyzed by ROC curve had very well diagnostic value for NAFL.Blood ALT and TG in NAFL had no relationship. Concentration of TG in men and women had no distinction statistically.

关 键 词：非酒精性脂肪肝 接收者工作特征曲线 三酰甘油 丙氨酸氨基移换酶 

分 类 号：R575.5[医药卫生—消化系统]