FibroScan在2型糖尿病合并NAFLD中的作用  

Significance and application of FibroScan in patients with type 2 diabetes mellitus complicated with NAFLD

作　　者：李瑜 裴晓艳[1] 沈晖[2] 金国玺[1] LI Yu;PEI Xiaoyan;SHEN Hui;JIN Guoxi(Department of Endocrinology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China;Department of Diagnosis,Bengbu Medical College)

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233000 [2]蚌埠医学院诊断教研室

出　　处：《包头医学院学报》2020年第2期5-8,共4页Journal of Baotou Medical College

基　　金：安徽省教育厅自然科学重点(KJ2019A0353);蚌埠医学院自然科学类项目(BYKF1801)。

摘　　要：目的:探究FibroScan在2型糖尿病合并非酒精性脂肪性肝病(NAFLD)中的意义及应用。方法:选取正常对照组(N)23例,2型糖尿病(T2DM)98例,其中T2DM合并NAFLD患者(DMF)70例,不伴NAFLD患者(DM)28例;NAFLD诊断采用Fibroscan?502TOUCH诊断标准,根据受控衰减参数CAP数值判定CAP<240 dB/m为正常,NAFLD患者CAP≥240 dB/m;对患者的血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、角蛋白-18(CK-18)及生化常规、糖化血红蛋白、胰岛β细胞功能等进行分析,探究FibroScan在T2DM合并NAFLD中的意义。结果:N组患者与T2DM组及DMF组相比,N组患者的IL-6、TNF-α、CK-18水平低于后两组(P<0.05);N组患者与DM组相比,IL-6、TNF-α、CK-18差异无统计学意义(P>0.05),DMF组患者的IL-6、TNF-α、CK-18水平均高于DM组患者(P<0.05);在相关性分析中,CAP与IL-6、TNF-α、CK-18呈正相关(P<0.05)。结论:FibroScan在T2DM合并NAFLD诊断中效果好于腹部彩超,FibroScan不仅可判断脂肪变性程度,还能反应肝脏炎症程度。Objective:To investigate the significance and application of FibroScan in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease(NAFLD).Methods:23 subjects were chosen as the normal control group(N)and 98 patients with type 2 diabetes mellitus(T2DM),among whom 70 patients had T2DM complicated with NAFLD(DMF)and 28 patients had T2DM without NAFLD(DM),were chosen.The diagnosis of NAFLD was based on the diagnostic criteria of Fibroscan 502TOUCH.According to the value of controlled attenuation parameter CAP,it was divided into the normal group(CAP<240dB/m)and NAFLD group(CAP>=240 db/m).The function of serum interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),keratin-18(CK-18)and biochemical routine,hemoglobin and islet beta cells of 121 subjects were statistically analyzed to study the significance of FibroScan in patients with type 2 diabetes mellitus complicated with NAFLD.Results:1.Compared with the traditional color ultrasound,FibroScan was superior in the diagnosis of early hepatic steatosis.2.Compared with both the T2DM and DMF groups,the levels of IL-6,TNF-α,and CK-18 in the N group were lower than those in the latter two groups,the difference being statistically significant.Compared with the DM group,there was no difference in terms of IL-6,TNF-αand CK-18 between the two groups,which indicated that IL-6,TNF-α,and CK-18 were related to the occurrence of NAFLD.3.Compared with the DM group,the levels of IL-6,TNF-α,and CK-18 in the DMF group were higher,the difference being statistically significant.In correlation analysis,the controlled attenuation parameter(CAP)was positively correlated with IL-6,TNF-α,and CK-18,the difference being significant,which indicated that CAP could not only be used to determine the extent of NAFLD steatosis,but also had a certain role in non-alcoholic fatty liver inflammation.Conclusion:The diagnosis of FibroScan is superior to abdominal color ultrasound in patients with type 2 diabetes mellitus complicated with NAFLD.In addition,FibroScan ca

关 键 词：FIBROSCAN CAP 2型糖尿病 NAFLD IL-6 TNF-Α CK-18 

分 类 号：R57[医药卫生—消化系统]