血清YKL-40、肝/脾CT值与非酒精性脂肪性肝炎严重程度的相关性研究  

Correlation between serum YKL-40,liver/spleen CT value and the severity of non-alcoholic steatohepatitis

作　　者：石文达[1] 崔志新[1] 张丹[1] 李桂萍[1] 王国玉[2] 赵晓彬 肖旭[3] SHI Wen-da;CUI Zhi-xin;ZHANG Dan(Radiology Department,South Hospital District,Affiliated Hospital of Chengde Medical University,Hebei Chengde,067000,China)

机构地区：[1]承德医学院附属医院南院区放射科 [2]承德医学院附属医院老年病科 [3]承德医学院附属医院临床药学部

出　　处：《中西医结合肝病杂志》2022年第3期269-271,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：承德市科技局科技支撑计划项目(No.201801A044)。

摘　　要：目的:分析血清哺乳动物几丁质酶样蛋白-40(YKL-40,又称人类软骨糖蛋白39)、肝/脾CT值与非酒精性脂肪性肝炎(NASH)严重程度的相关性,以期为临床的早期诊断提供依据。方法:选择2018年8月至2020年8月我院收治的NASH患者159例为研究样本,依据NASH患者的病情严重程度进行分组,NASH轻度组(简称轻度组)、NASH中度组(简称中度组)、NASH重度组(简称重度组)分别为59、54、46例,并选取同时间段内的48例健康体检者为对照组。采用双夹心抗体酶联免疫吸附法检测血清YKL-40水平,均行肝脏CT扫描测定肝(L)/脾(S)CT值,观察4组人员血清YKL-40水平、L/S值的差异,分析血清YKL-40、L/S CT值与病情严重程度的相关性;并采用ROC曲线探讨该两项指标对NASH患者病情的诊断价值。结果:对照组、轻度组、中度组、重度组患者血清YKL-40水平、L/S值比较,差异均有显著统计学意义(P<0.001)。Spearman等级相关性分析结果显示,血清YKL-40与病情严重程度呈正相关性;L/S值与病情严重程度呈负相关性(均P<0.001)。当血清YKL-40临界值为159 ng/ml,L/S值为0.455时对NASH患者病情严重程度诊断价值最高;AUC面积分别为0.841、0.790,差异均有统计学意义(P<0.001)。结论:随着病情的发展NASH患者血清YKL-40、L/S值分别呈现逐渐升高、下降的趋势,该两项指标与NASH患者的病情严重程度具有相关性。Objective:To analyze the correlation between serum YKL-40,liver/spleen CT value and the severity of non-alcoholic steatohepatitis(NASH) in order to provide evidence for early clinical diagnosis.Methods:A total of 159 NASH patients admitted to our hospital from August 2018 to August 2020 was finally included as the research sample.The NASH patients were divided into groups according to the severity of the disease,NASH mild group,NASH moderate group,NASH severe groups were 59,54,46 cases,respectively,and selected 48 health checkups in the same time period as the control group.Double-sandwich antibody enzyme-linked immunosorbent assay was used to detect serum YKL-40 levels,liver CT scans were used to determine liver(L) and spleen(S) CT values,and the differences in serum YKL-40 levels and L/S values in the four groups were observed.Analyze the correlation between serum YKL-40,L/S values,and the severity of the disease,and use ROC curve to explore the diagnostic value of these two indicators in NASH patients.Results:The comparison of serum YKL-40 levels and L/S values among the contrast group,NASH mild group,NASH moderate group,and NASH severe group showed significant differences(P<0.001).The results of Spearman rank correlation analysis showed that serum YKL-40 was positively correlated with the severity of the disease,and the L/S value was negatively correlated with the severity of the disease(all P<0.001).When the serum YKL-40 cut-off value was 159 ng/ml and the L/S value was 0.455,the diagnostic value of the severity of NASH patients was the highest.The AUC areas were 0.841 and 0.790,respectively,and the differences were statistically significant( P < 0.001).Conclusion:Serum YKL-40 and L/S values in NASH patients show a gradual increase and decrease trend with the development of the disease.These two indicators are correlated with the severity of the disease in NASH patients.

关 键 词：非酒精性脂肪性肝炎 血清YKL-40 肝/脾CT值 病情严重程度 相关性 

分 类 号：R445.4[医药卫生—影像医学与核医学]