非酒精性脂肪肝病变程度的超声诊断及评定效果分析  

Ultrasonic diagnosis and evaluation of the degree of nonalcoholic fatty liver disease

作　　者：范晓华[1] 赵红星[2] FAN Xiaohua;ZHAO Hongxing(Department of Radiology,Huzhou First People's Hospital in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第一人民医院超声科,浙江湖州313000 [2]浙江省湖州市第一人民医院放射科,浙江湖州313000

出　　处：《中国现代医生》2019年第1期101-104,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY774)

摘　　要：目的研究超声技术对评价非酒精性脂肪肝(NAFLD)的病变程度方面临床价值。方法回顾性分析2016年4月～2017年11月我院收治的176例非酒精性脂肪肝患者,其中包括轻度脂肪肝(54例)、中度脂肪肝(62例)和重度脂肪肝(60例),设为研究组,另外选择55例健康受试者作为对照组。所有受试者接受SWE检查并检测肝功能指标。比较研究组与对照组间的肝脏杨氏模量值、肝功能指标以及血脂水平,分析杨氏模量值与肝功能指标的相关性。结果轻度脂肪肝组的肝脏杨氏模量值与对照组相比差异无统计学意义(P>0.05)。中度和重度脂肪肝组的肝脏杨氏模量值与对照组相比差异有统计学意义(P<0.01)。中度或重度脂肪肝组AST、ALT、AKP等肝功能指标水平明显大于对照组,差异有统计学意义(P<0.05或P<0.01),而轻度脂肪肝组与对照组比较差异无统计学意义(P>0.05)。轻度、中度及重度脂肪肝各组间TC、TG和LDL-C明显高于对照组,中、重度组HDL-C值低于对照组,对照组与脂肪肝组间TG和HDL-C值差异有统计学意义(P<0.05),TC和LDL-C值的差异无统计学意义(P>0.05)。肝脏杨氏模量值与AST、ALT呈正相关(P<0.05),与AKP呈负相关(P<0.05),与非酒精性脂肪肝病变程度呈正相关(P<0.05)。结论 SWE作为评价非酒精性脂肪肝的一种无创诊断技术,在评价NAFLD病变程度上具有一定的指导意义,但仍需更大样本量的临床研究数据来为临床应用提供依据。Objective To investigate and analyze the clinical value of ultrasound examination in different degrees of non-alcoholic fatty liver disease.Methods 176 patients with non-alcoholic fatty liver in our hospital from April 2016 to November 2017 were analyzed retrospectively.All patients were divided into three groups:mild fatty liver group(n=54),moderate fatty liver group(n=62)and severe fatty liver group(n=60),55 healthy subjects were selected as control group.All subjects underwent SWE,Hepatic function examination and blood lipid level,Young'modulus of the liver were compared and analyzed between study group and control group.Results There was no significant difference in liver Young's modulus between the mild fatty liver group and the control group(P >0.05).The liver Young's modulus of moderate and severe liver fatty group were higher than the control group(P<0.01).AST,ALT,and AKP values of moderate or severe fatty liver group were significantly higher than control group(P<0.05).The values of TC,TG and LDL-C in mild,moderate and severe fatty liver group were significantly higher than control group.The HDL-C values were lower than control group(P<0.05).There were significant differences in TG and HDL-C between the control group and fatty liver groups.Spearman correlation analysis showed that the liver Young's modulus was positively correlated with AST and ALT(P<0.05),negative correlation with AKP(P<0.05),and positively correlated with the severity of non-alcoholic fatty liver disease(P<0.05).Conclusion As a non-invasive diagnostic technique,SWE has certain clinical value in evaluating severity degrees of non-alcoholic fatty liver disease.However,larger sample size of clinical researches are still needed,which provide evidence for clinical application.

关 键 词：非酒精性脂肪肝 超声检查 杨氏模量 肝功能 

分 类 号：R575.5[医药卫生—消化系统]