超声影像技术与FibroTouch在体检中的应用  

Application of the ultrasonic imaging techniques and FibroTouch in health examination

作　　者：徐信 孙亚玲[1] 朱丽琴 杨玲[2] 杨锐[1] XU Xin;SUN Yaling;ZHU Liqin;YANG Ling;YANG Rui(Department of Health Examination;Department of Gastroenterology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院体检中心,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院消化内科,湖北武汉430022

出　　处：《胃肠病学和肝病学杂志》2018年第11期1285-1289,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：中国健康促进基金会"体检人群非传染性肝病早期风险筛查及干预"项目(CHPF2014-FT-01)

摘　　要：目的探讨脂肪肝人群中Fibro Touch检测结果与肝脏B超的一致性及其影响因素。方法获取762例进行Fibro Touch检查的脂肪肝患者的体质量指数(BMI)、颈部血管B超、肝脏B超、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein,HDL)、低密度脂蛋白(low density lipoprotein,LDL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、脂肪衰减参数(fat attenuation parameter,FAP)及肝脏硬度值(liver stiffness measurement,LSM)等资料,分析受检者以上数据之间的相关性。结果 BMI≥24 kg/m^2的受检者FAP和LSM显著高于<24 kg/m^2的受检者; TC≥1. 7 mmol/L的受检者FAP和LSM显著高于TC <1. 7 mmol/L的受检者; TG≥5. 2 mmol/L的受检者FAP高于TG <5. 2 mmol/L的受检者;轻度以上脂肪肝的受检者FAP和LSM均高于轻度脂肪肝的受检者;年龄≥40岁的受检者FAP和LSM均高于年龄<40岁者;随着年龄的增长,FAP及LSM的数值在升高,颈部血管斑块阳性率也在升高; FAP和LSM均与肝脏B超结论呈高度正相关。结论 BMI、TG和肝脏B超是Fibro Touch检查的敏感指标,Fibro Touch作为肝纤维化及脂肪含量的无创量化检查,以上四个与之相关性很高的敏感指标结果的异常,可提示体检者做肝脏硬度及脂肪含量的进一步检查;随着年龄的增长,FAP及LSM升高的受检者,应注意颈动脉硬化的风险;肝脏B超结论与FAP和LSM数值均呈高度正相关,Fibro Touch对于肝脏检查的准确性得到了进一步验证。Objective To investigate the consistency of FibroTouch test and liver B ultrasound in fatty liver population and its influencing factors. Methods Body mass index（ BMI）,cervical vascular B-mode ultrasound,liver B-mode ultrasound,total cholesterol（ TC）,triglyceride（ TG）,high density lipoprotein（ HDL）,low density lipoprotein（ LDL）, aspartate transaminase（ AST）, alanine aminotransferase（ ALT）, γ-glutamyltransferase（ GGT）, fat attenuation parameter（ FAP） and liver stiffness measurement（ LSM） were obtained from 762 patients with fatty liver who underwent Fibro Touch examination. Results Fat attenuation and liver stiffness in subjects with BMI（ 〉24 kg/m^2） were significantly higher than those with 〈24 kg/m^2. Fat attenuation and liver stiffness in subjects with TC（ 〉1. 7 mmol/L） were significantly higher than those with TC 〈1. 7 mmol/L. Fat attenuation in subjects with TG（ 〉5. 2 mmol/L） was higher than that in subjects with TG 〈5. 2 mmol/L. Fatty liver above mild degree was higher than that of TG 5. 2 mmol/L.Fat attenuation parameters and liver stiffness values were higher in patients with mild fatty liver than in patients with mild fatty liver. Fat attenuation parameters and liver stiffness values were higher in patients aged over 40 years old than those aged under 40 years old. FAP and LSM values were increased with age,and the positive rate of cervical vascular plaque was also increased. FAP and LSM were both related to liver B-ultrasonography. There was a highly positive correlation.Conclusion BMI,TG and B-mode ultrasonography are sensitive indicators of FibroTouch examination. FibroTouch is a non-invasive quantitative examination of liver fibrosis and fat content. Abnormal results of the above four sensitive indicators,which are highly correlated with them,may indicate that the liver hardness and fat content should be further examined by physical examiners. FAP and LSM increase with age. The risk of carotid atherosclerosis should be paid attention to.

关 键 词：超声影像技术 瞬时弹性成像技术 脂肪衰减参数 脂肪肝 

分 类 号：R575.5[医药卫生—消化系统]