肝功能酶学指标联合血脂指标在酒精性脂肪肝与非酒精性脂肪肝中的鉴别作用  

Differential Effect of Liver Function Enzymology Index and Blood Lipid Index in alcoholic fatty Liver and nonalcoholic fatty Liver

作　　者：金中玲 JIN Zhongling(Department of Laboratory Medicine,Fengqiu County People's Hospital,Xinxiang,Henan 453300,China)

机构地区：[1]封丘县人民医院检验科,河南新乡453300

出　　处：《临床研究》2022年第7期157-160,共4页Clinical Research

摘　　要：目的探讨肝功能酶学指标联合血脂指标在酒精性脂肪肝与非酒精性脂肪肝中的鉴别作用。方法选取封丘县人民医院2019年4月至2021年8月收治的酒精性脂肪肝合计108例患者设为AFLD组,另选取同时间段内本院100例非酒精性脂肪肝患者设为NAFLD组,比较两组肝功能指标和血脂指标检测结果,分析其鉴别作用。结果AFLD组肝功能指标中AST、ALT和GGT均高于NAFLD组,差异有统计学意义(P<0.05),AFLD组血脂指标中TG水平低于NAFLD组,TC、LDL-C、HDL-C相比,差异无统计学意义(P>0.05);AFLD组中TG异常率低于NAFLD组、AST、AST/ALT≥2、GGT及联合检测的异常率均明显高于NAFLD组,差异有统计学意义(P<0.05),其余指标相比,差异无统计学意义(P>0.05)。肝功能指标与血脂指标联合诊断鉴别酒精性脂肪肝与非酒精性脂肪肝的准确率、敏感度、特异度、阳性预测值及阴性预测值均高于肝功能或血脂单项检测,诊断效能较高,差异有统计学意义(P<0.05)。结论酒精性脂肪肝患者部分肝功能指标与血脂指标与非酒精性脂肪肝患者存在差别,其中AST、AST/ALT(≥2)、GGT及TG等指标是鉴别酒精性脂肪肝与非酒精性脂肪肝有效的诊断指标,此外将二者联合检测可提高鉴别准确性,值得应用到临床。Objective To explore the role of liver function enzymology index combined with blood lipid index in differentiating alcoholic fatty liver from nonalcoholic fatty liver.Methods A total of 108 patients with alcoholic fatty liver admitted to Fengqiu County People's Hospital from April 2019 to August 2021 were selected as AFLD group,and 100 patients with nonalcoholic fatty liver in the same period were selected as NAFLD group.The results of liver function and blood lipid indexes were compared between the two groups,and their differential effects were analyzed.Results AST,ALT and GGT in AFLD group were significantly higher than those in NAFLD group(P<0.05);The level of TG in AFLD group was lower than that in NAFLD group.and there was no significant difference in TC,LDL-C and HDL-C between the two groups(P>0.05);The abnormal rate of TG in AFLD group was lower than that in NAFLD group,and the abnormal rates of AST,AST/ALT≥2,GGT and combined detection were significantly higher than that in NAFLD group(P<0.05),other indicators between groups were not significantly different(P>0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of combined diagnosis of liver function index and blood lipid index in distinguishing alcoholic fatty liver from nonalcoholic fatty liver were higher than those of single detection of liver function or blood lipid,and the diagnostic efficiency was higher with statistical significance(P<0.05).Conclusion There are differences in some liver function indexes and blood lipid indexes between patients with alcoholic fatty liver and patients with nonalcoholic fatty liver.Among them,AST,AST/ALT(≥2),GGT and TG are effective diagnostic indexes to distinguish alcoholic fatty liver and nonalcoholic fatty liver.In addition,the combined detection of the two can improve the accuracy of differentiation and is worthy of clinical application.

关 键 词：肝功能指标 血脂 酒精性脂肪肝 非酒精性脂肪肝 诊断 

分 类 号：R575.2[医药卫生—消化系统]