受控衰减指数对健康体检人群脂肪肝的定量诊断价值  

Controlled attenuation parameter for steatosis assessment in health checkup groups

作　　者：赵奕[1] 宋震亚[1] 武建军[2] 王六红[3] 叶慧义[4] 袁豪杰 王英伟[4] 吴婷[5] 袁思殊 曾强[2] Zhao Yi;Song Zhenya;Wu Jianjun;Wang Liuhong;Ye Huiyi;Yuan Haojie;Wang Yingwei;Wu Ting;Yuan Sishu;Zeng Qiang(International Healthcare Center&General Medicine Department,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Health Management Institute,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Radiology Department,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Radiology and Image Department,Chinese PLA General Hospital,Beijing 100853,China;Infectious Disease Department,Tongji Hospital of Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China;Radiology Department,Tongji Hospital,Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]浙江大学医学院附属第二医院国际保健中心/全科医学科,杭州310009 [2]解放军总医院第二医学中心健康管理研究院,北京100853 [3]浙江大学医学院附属第二医院放射科,杭州310009 [4]解放军总医院放射影像科,北京100853 [5]华中科技大学同济医学院附属同济医院感染科,武汉430030 [6]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《中华健康管理学杂志》2020年第4期313-317,共5页Chinese Journal of Health Management

摘　　要：目的评估受控衰减指数(CAP)对健康体检人群非酒精性脂肪性肝病的定量诊断价值。方法在健康体检中心开展一项全国多中心研究,2014年4月至12月共纳入173例受检者,均完成身高、体重、血压等人体学指标测量,进行血常规、肝功能、血脂等检测,以及FibroScan和磁共振质子密度脂肪含量(MRI-PDFF)检查。采用Spearman系数和Pearson系数描述MRI-PDFF与CAP的相关性。应用受试者工作特征曲线及曲线下面积评估CAP的诊断效能,并根据Youden指数确定最佳截断值。结果入组受检者年龄(45.0±10.5)岁,体质指数(25.8±4.0)kg/m^2。CAP值和lg转换的MRI-PDFF值呈线性相关(Pearson系数=0.772,P<0.001)。CAP区分非脂肪肝(S0)和轻度脂肪肝(S1)的截断值为244 dB/m。结论CAP与MRI-PDFF测得的肝脂肪含量显著相关,并能对肝脂肪变性程度进行分级,可作为常规健康体检中筛查脂肪肝的工具。Objective To evaluate the quantitative diagnostic value of controlled attenuation parameter(CAP)in health checkup groups with asymptomatic nonalcoholic fatty liver disease.Methods A multicenter prospective study was conducted among Chinese individuals undergoing regular health checkups;a total of 173 subjects were investigated.Human body indexes such as height,weight,and blood pressure were measured,and complete blood count,liver function,blood lipid,FibroScan,and MRI-PDFF examinations were performed.Correlation between MRI-PDFF and CAP was described using Spearman′s and Pearson′s coefficients.Diagnostic efficacy of the CAP was evaluated using the subject work characteristic curve and the area under this curve,and the optimal cut-off value was determined according to the Youden index.Results The average age and body mass index of the subjects were 45.0±10.5 years and 25.8±4.0 kg/m^2,respectively.A linear correlation was found between CAP and lg transformed magnetic resonance imaging-based proton density fat fraction results(Pearson′s coefficient 0.772,P<0.001).When optimized for≥90%sensitivity,the CAP cutoff for staging≥S1 steatosis was 244 dB/m.Conclusions The CAP result was significantly correlated with the liver fat fraction measured by MRI-PDFF,and capable of differentiating steatosis grades.CAP can be used as a tool for screening fatty liver in health checkup groups.

关 键 词：非酒精性脂肪性肝病 无创评估 受控衰减指数 磁共振质子密度脂肪含量 

分 类 号：R575.5[医药卫生—消化系统]