筛选脂肪肝分级诊断最佳预测指标的实验研究  

Selection of the most powerful predictors for the evaluation of hepatic steatosis grade:an experimental study

作　　者：苏中振[1] 练荣丽[2] 何炳钧[1] 孟晓春[1] 单鸿[1] 

机构地区：[1]中山大学附属第三医院放射科,510630 [2]中山大学附属第三医院感染

出　　处：《中国实用医药》2009年第19期1-3,共3页China Practical Medicine

基　　金：广东自然科学基金团队研究项目基金资助(项目编号:05200177);广东省自然科学基金(项目编号:06021217)

摘　　要：目的筛选和寻找脂肪肝分级诊断的最佳预测指标。方法45只健康新西兰大白兔,采用高脂高糖饲料加酒精饮料建立不同程度脂肪肝模型,应用肉眼观测、血生化、超声、计算机断层扫描(CT)及氢磁共振波谱(1HMRS)多种临床诊断手段,观测22个指标并进行对照研究。结果在所选择的22个观测指标中,肝脏湿重、肝脏指数、肝CT值、肝/腰大肌密度比率、1HMRS脂肪峰值、脂肪波峰下面积、脂/水波峰下面积比率、脂肪百分比、超声衰减系数、谷草转氨酶(AST)、血清胆固醇(CHOL)、三酰甘油(TG)等12个指标总体均数存在组间差异性,且与脂肪肝分级具有显著性相关,其中肝脏指数、肝CT值和血清胆固醇为脂肪肝分级诊断的最佳预测指标,相关系数分别为0.709,-0.764,0.886,判断脂肪肝分级的回归方程Y=1.975+3.906×10-2X1+0.369X2-2.84×10-2X3,Y:脂肪肝分级,X1:血清胆固醇,X2:肝脏指数,X3:肝CT值。结论联合应用多种诊断手段,综合考虑多个最佳预测指标的诊断方法,能够为临床快速、准确地判断脂肪肝程度提供帮助。Objective To select the most powerful predictors for the evaluation of hepatic steatosis grade. Methods Forty-five healthy New Zealand rabbits were randomly divided into normal control and three experimental groups. Hepatic steatosis models were established by giving high fat, high sugar diet with drinking water containing five percent ethanol. Twenty-two variable indexes were measured with general observation, biochemical indexes, Ultrasonography, CT, 1 H MRS. Results By statistical analysis, there were twelve variable indexes with significant differences among groups and correlated with hepatic steatosis grade, they were liver weight, hepatic index, liver CT value, liver-muscle density ratio, 1H MRS fat peak value, fat peak area, fatwater peak area ratio, fat percent, ultrasound attenuation coefficient, serum AST, CHOL, TRIG. Among them hepatic index, liver CT value and serum CHOL were selected as the most powerful predictors for hepatic steatosis grade, correlation coefficients were 0. 709, -0. 764, 0. 886, respectively, regression equation was Y = 1. 975 ＋3. 906× 10^-2X1 ＋ 0. 369X2-2. 84 × 10^-2X3, Y： hepatic steatosis grade, XI： serum CHOL, X2： hepatic in- dex, X3 ： liver CT value. Conclusion Combined application of the several diagnostic methods is hopeful to improve the rapid, accurate evaluation grade of fatty liver.

关 键 词：脂肪肝 诊断 最佳预测指标 实验研究 

分 类 号：R575.5[医药卫生—消化系统]