脂肪肝的超声定量诊断及其与糖脂代谢等因素的相关性  

Ultrasonic quantitative diagnosis of fatty liver and its relationship with factors like lipid and glucose metabolism

作　　者：李辰[1] 

机构地区：[1]青海省人民医院超声科,青海西宁810007

出　　处：《实用临床医药杂志》2016年第21期80-83,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11526831)

摘　　要：目的探讨脂肪肝的超声定量诊断及其与糖脂代谢等因素的相关性。方法 108例脂肪肝患者根据MR平扫及1H-MRS成像检测结果分为轻度、中度、重度脂肪肝组,每组36例。本院同期健康体检中心的40名健康志愿者为对照组。各组受试者均进行肝脏超声检查,测量并计算出肝左叶、肝右叶(分为近场、中场、后场)的弥漫性脂肪肝回声强度(EI)值。采用相关生化检测方法检测各组受试者血中肝酶、血脂、血糖水平。并进一步分析肝脏脂肪含量与肝酶、血脂、血糖各指标进行相关性。结果各脂肪肝组右肝近场、右肝中场、左肝的EI值均明显高于对照组,右肝远场EI值均明显低于对照组(P<0.05或P<0.01)。随着脂肪肝程度的增加,右肝近场、右肝中场、左肝的EI值明显增加,右肝远场EI值明显降低(P<0.05或P<0.01)。各脂肪肝组中,血中肝酶、血脂、血糖水平均明显高于对照组(P<0.05或P<0.01)。随着脂肪肝程度的加重,血中肝酶、血脂、血糖水平呈逐渐增加趋势(P<0.05或P<0.01)。肝脏脂肪含量与丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、甘油三酯、高密度脂蛋白、载脂蛋白A、载脂蛋白B、载脂蛋白E、空腹血糖、餐后2 h血糖水平呈显著正相关(P<0.05或P<0.01)。结论脂肪肝与高血糖、高血脂及肝功能损害有一定关联性。超声定量肝脏脂肪含量方法简便,灵敏度高,有助于对脂肪肝严重程度的判断,及指导临床医师帮助患者控制血糖及血脂水平。Objective To explore the ultrasonic quantitative diagnosis of fatty liver and its relationship with factors like lipid and glucose metabolism. Methods A total of 108 patients with fatty liver were divided into mild,moderate and severe fatty liver groups according to magnetic resonance（ MR） plain scanning and hydrogen magnetic resonance spectroscopy（1H-MRS） imaging detection results,36 cases for each group. And another 40 healthy volunteers receiving physical examinations served as control group. Hepatic ultrasonic detection was conducted to all subjects to measure the echo intensity（ EI） value of diffuse fatty liver of left and right lobes of liver（ it was classified into near field,midfield and backfield）. Correlating biochemical detection was used to detect the levels of serum liver enzyme,blood lipid and blood glucose. And the relationships between fat content in liver with the levels of serum liver enzyme,blood lipid and blood glucose were further analyzed. Results EI values in near field and midfield of right lobes of liver as well as in left lobe of liver were markedly higher but was notably lower in backfield of right lobe of liver in all fatty liver groups than that in control group（ P〈0. 05 or P〈0. 01）. With the increase of severity of fatty liver,EI values in near field and midfield of right lobes of liver as well as in left lobe of liver increased while that in backfield of right lobe of liver decreased（ P〈0. 0 5 or P〈0. 0 1）. In addition,levels of serum liver enzyme,blood lipid and blood glucose were prominently higher in each fatty liver group than that in control group（ P〈0. 05 or P〈0. 01）,and gradually increased along with the severity of fatty liver（ P〈0. 05 or P〈0. 01）. Fat content in liver was in positive association with the levels of alanine aminotransferase（ ALT）,glutamic oxalacetic transaminase（ AST）,γ- glutamyl transpeptidase（ γ-GT）,triglyceride,high-density lipoprotein,apolipoprotein-A,apolipoprotein-B,apolipoprotein-E,fasting p

关 键 词：脂肪肝 超声 定量 血脂 血糖 肝功能 

分 类 号：R575.6[医药卫生—消化系统]