血清瘦素及可溶性瘦素受体在诊断非酒精性脂肪肝合并肝纤维化中的价值  

The Value of Serum LP and SLP in the Diagnosis of Non-alcoholic Fatty Liver Disease with Liver Fibrosis

作　　者：龚尚红 曹雨石 郑小蝶 秦芳怡 杜晓晨 徐巧本 GONG Shanghong;CAO Yushi;ZHENG Xiaodie;QIN Fangyi;DU Xiaochen;XU Qiaoben(Traditional Chinese Medicine Hospital of Songzi,Songzi 434200,China)

机构地区：[1]湖北省松滋市中医院,湖北松滋434200

出　　处：《中国医学创新》2021年第13期60-64,共5页Medical Innovation of China

摘　　要：目的:观察血清瘦素(LP)及可溶性瘦素受体(SLP)在诊断非酒精性脂肪肝(NAFLD)合并肝纤维化中的价值。方法:选取2018年5月-2019年5月本院收治的72例NAFLD患者作为NAFLD组。同期选择35例本院门诊健康体检者作为对照组。根据非酒精性脂肪性肝纤维化评分(nonalcoholic fatty liver disease fibrosis score,NAFLDFS)将NAFLD组分为NAFLD无肝纤维化组(A组,NAFLDFS<-1.455,45例)与NAFLD伴肝纤维化组(B组,NAFLDFS≥-1.455,27例)。检测并比较各组血清LP、SLP、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原、层黏蛋白(LN)、透明质酸(HA)及血清空腹血糖(FBG);计算并比较各组胰岛素抵抗指数(HOMA-IR)、NAFLDFS及BMI。分析上述血清学指标诊断NAFLD患者合并肝纤维化的价值。结果:NAFLD组血清PCⅢ、Ⅳ型胶原、LN、HA、FBG、LP水平及HOMA-IR、BMI均明显高于对照组,而血清SLP水平明显低于对照组(P<0.05);B组血清PCⅢ、Ⅳ型胶原、LN、HA、FBG、LP水平均明显高于A组,而血清SLP表达水平明显低于A组(P<0.05),两组HOMA-IR、BMI比较,差异均无统计学意义(P>0.05);LP、SLP诊断NAFLD患者合并肝纤维化的AUC、敏感度及特异度均优于PCⅢ、Ⅳ型胶原、LN、HA、FBG。结论:血清LP及SLP在诊断NAFLD合并肝纤维化方面具有较好的临床价值。Objective:To observe the value of serum LP and SLP in the diagnosis of non-alcoholic fatty liver disease(NAFLD)with liver fibrosis.Method:A total of 72 patients with NAFLD admitted to our hospital from May 2018 to May 2019 were selected as the NAFLD group.During the same period,35 healthy subjects were selected as the control group.According to the nonalcoholic fatty liver disease fibrosis score(NAFLDFS),the NAFLD group was divided into the NAFLD group without liver fibrosis(group A,NAFLDFS<-1.455,45 cases)and NAFLD with liver fibrosis group(group B,NAFLDFS≥-1.455,27 cases).The levels of serum LP,SLP,PCⅢ,collagen typeⅣ,LN,HA,FBG of all groups were detected and compared.The HOMA-IR,NAFLDFS,BMI of all groups were calculated and compared.The value of the above serological indexes in the diagnosis of liver fibrosis in NAFLD patients was analyzed.Result:The levels of serum PCⅢ,collagen typeⅣ,LN,HA,FBG,LP and the HOMA-IR,BMI of the NAFLD group were significantly higher than those of the control group,while the level of serum SLP was significantly lower than that of control group(P<0.05).The levels of serum PCⅢ,collagen typeⅣ,LN,HA,FBG,LP of group B were significantly higher than those of group A,while the level of serum SLP was lower than that of group A(P<0.05),and there were no significant differences in HOMA-IR and BMI between the two groups(P>0.05).The AUC,sensitivity and specificity of LP,SLP in diagnosis of NAFLD with hepatic fibrosis were superior to PCⅢ,collagen typeⅣ,LN,HA,FBG.Conclusion:Serum LP and SLP have good clinical value in the diagnosis of NAFLD with liver fibrosis.

关 键 词：瘦素 可溶性瘦素受体 非酒精性脂肪肝 肝纤维化 

分 类 号：R575[医药卫生—消化系统]