无创模型对人类免疫缺陷病毒感染者肝细胞脂肪变性的诊断价值  

Diagnostic value of non-invasive model for hepatic steatosis in patients infected with human immunodeficiency virus

作　　者：张德发[1] 李爽[1] 宓余强[1] 马萍[1] Zhang Defa;Li Shuang;Mi Yuqiang;Ma Ping(The Second People Hospital of Tanjin,Tianjin Medical Research Insititute of Liver Disease,Tianjin 300192,China)

机构地区：[1]天津市第二人民医院天津市肝病研究所,300192

出　　处：《中华肝脏病杂志》2020年第9期790-793,共4页Chinese Journal of Hepatology

基　　金："十三五"国家科技重大专项(2018ZX10302104)。

摘　　要：目的肝细胞脂肪变性在人类免疫缺陷病毒(HIV)感染人群中存在较高的发病率,目前尚无有效的无创方法能对其进行评估。本研究旨在评估无创模型对该人群肝细胞脂肪变性的诊断价值。方法采用单中心回顾性研究:(1)评估受控衰减参数(CAP)和肝细胞脂肪变性指数(HSI)对HIV感染者肝细胞脂肪变性的诊断价值。(2)评估无创模型对糖脂代谢异常引起的肝细胞脂肪变性和丙型肝炎病毒感染造成肝细胞脂肪变性的鉴别能力。(3)评估上述模型对HIV/丙型肝炎病毒共感者肝细胞脂肪变性的诊断价值。用诊断试验及受试者工作特征曲线分析评价模型的诊断价值。结果(1)对HIV感染者肝细胞脂肪变性诊断价值:当CAP=232 dB/m时其敏感度为89.2%,特异度为78.1%;当HSI=34时,其敏感度为79.1%、特异度为83.2%。(2)对造成HIV感染者肝细胞脂肪变性原因的鉴别能力:当CAP=258 dB/m时其敏感度为81.5%,特异度为88.2%;HSI=37时,其敏感度为70.7%、特异度为92.4%。(3)对HIV/丙型肝炎病毒共感染者肝细胞脂肪变性的诊断价值:当CAP=241 dB/m时其敏感度为80%,特异度为71.4%;HSI=32时,其敏感度为73%、特异度为68.9%。结论CAP和HSI对HIV感染者肝细胞脂肪变性具有较好的诊断价值。Objective Hepatic steatosis has a high incidence in human immunodeficiency virus(HIV)infected people,and there is no effective non-invasive method to evaluate it.This study aims to evaluate the diagnostic value of non-invasive models for hepatic steatosis in this population.Methods A single-center retrospective study was applied to evaluate:(1)the diagnostic value of controlled attenuation parameters(CAP)and hepatic steatosis index(HSI)in HIV-infected patients with hepatic steatosis;(2)the ability of the non-invasive model to distinguish hepatic steatosis caused by abnormal glucose and lipid metabolism and hepatic steatosis caused by hepatitis C virus infection;(3)the diagnostic value of the above models for hepatic steatosis in patients co-infected with HIV/hepatitis C virus.The diagnostic value of the model was analyzed and evaluated by diagnostic test and receiver operating characteristic curve.Results(1)the diagnostic value of hepatic steatosis for HIV-infected patients:when CAP=232 dB/m,the sensitivity and specificity were 89.2%and 78.1%,respectively;when HSI=34,the sensitivity and specificity were 79.1%and 83.2%,respectively.(2)The ability to identify the causes of hepatic steatosis in HIV-infected patients:when CAP=258dB/m,the sensitivity and specificity were 81.5%and 88.2%,respectively;when HSI=37,the sensitivity and specificity were 70.7%and 92.4%,respectively.(3)The diagnostic value of hepatic steatosis in patients co-infected with HIV/hepatitis C virus:when CAP=241 dB/m,the sensitivity and specificity were 80%and 71.4%,respectively;when HSI=32,the sensitivity and specificity were 73%and 68.9%,respectively.Conclusion CAP and HSI have superior diagnostic value for hepatic steatosis in patients infected with HIV.

关 键 词：脂肪类 诊断 HIV 

分 类 号：R575[医药卫生—消化系统] R512.91[医药卫生—内科学]