FibroTouch脂肪衰减参数在慢性乙型肝炎合并非酒精性脂肪肝患者中的应用价值  

The value of FibroTouch fat attenuation parameter in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease

作　　者：毛重山[1] 宁会彬 何佳[1] 殷辉[1] 康谊[1] 尚佳[1] 

机构地区：[1]河南省人民医院感染性疾病科,郑州450003

出　　处：《中华传染病杂志》2015年第6期339-342,共4页Chinese Journal of Infectious Diseases

基　　金：国家临床重点专科建设项目（2013年度）

摘　　要：目的探讨FibroTouch脂肪衰减参数对CHB合并非酒精性脂肪性肝病（NAFLD）患者的诊断价值。方法2014年1月至2015年3月河南省人民医院感染性疾病科收治的CHB患者115例为研究对象，分为单纯CHB组61例及CHB合并NAFLD组54例，分析FibroTouch在肝脏炎性反应、纤维化及脂肪肝的诊断价值及相关因素的关系，对其中的计量资料采用t检验，组间差异采用单因素方差分析，对其中的计数资料采用x。检验。结果115例患者肝脏硬度值为（8．22±6．33）kPa，脂肪衰减参数为（242．37±31．56）db／m，CHB合并NAFLD组患者脂肪衰减参数、体质指数（BMI）、总胆固醇、三酰甘油和血糖均高于单纯CHB组，差异均有统计学意义（均P〈0．05）。54例CHB合并NAFLD组患者，依据脂肪变程度分为轻度、中度、重度，结果显示脂肪变程度越重脂肪衰减参数就越高（P〈0．05），且脂肪衰减参数的敏感度为92．6％，特异度为85．0％。在相同的炎性反应及纤维化程度上，CHB合并NAFLD组患者脂肪衰减参数均高于单纯CHB组患者，差异均有统计学意义（均P〈0．05）。而各组患者的脂肪衰减参数在不同的炎症分级（x^2=5．901，P=0．117）及纤维化分期（x^2=4．073，P=0．254）中的差异无统计学意义。结论FibroTouch作为一种新的无创性诊断方式，可以较好地反映CHB患者的脂肪变程度，推荐应用于CHB合并NAFLD患者的临床诊治。Objective To explore the diagnostic value of FibroTouch fat attenuation parameter in patients with chronic hepatitis B （CHB） complicated with nonalcoholic fatty liver disease （NAFLD）. Methods One hundred and fifteen CHB patients hospitalized in Hernan Provincial People＇s Hospital from Jan 2014 to Mar 2015 were divided into two groups： 61 CHB only and 54 complicated with NAFLD. The diagnostic value and related factors of FibroTouch in liver inflammation, fibrosis and fatty liver disease were analyzed. Student t test was used in quantitative data analysis, and difference between groups was analyzed by using one-way analysis of variance （ANOVA）. The qualitative data were compared by ehisquare test. Results In 115 patients, the liver stiffness value was （8.22±6.33） kPa, fat attenuation parameter was （242. 37±31.56） db/m. The fat attenuation parameters, body mass index （BMI）, total cholesterol, triacylglycerol and glucose of CHB patients with NAFLD group were higher than those of CHB group, with statistically significant differences （all P〈0.05）. Fifty-four patients diagnosed with CHB complicated with NAFLD were divided into mild, moderate and severe subgroups according to the degree of liver fat. The fat attenuation parameter increased along with the degree of liver fat （P〈0.05）. The sensitivity of fat attenuation parameter was 92.6% and the specificity was 85.0 %. In same grades of fibrosis and inflammation, the fat attenuation parameter of patients with CHB complicated with NAFLD was higher than patients with CHB only, with statistically significant difference （P〈0.05）. However,there were no statistically significant differences of fat attenuation parameter with different degree of liver inflammation （x^2= 5. 901, P = 0. 117） and fibrosis （x^2 = 4. 07a, P= 0. 254） in the two groups. Conclusions As a new noninvasive diagnostic method, FibroTouch can reflect the degree of fat of the liver, which could be recommended as the clinical diagnosis tool for CHB complic

关 键 词：FibroTouch 病毒性肝炎 乙型 慢性 非酒精性脂肪肝 炎症 纤维化 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]