超声背向散射积分技术血清沉默信息调节因子2相关酶1及核苷酸结合寡聚化结构域样受体蛋白3联合诊断老年肝炎性脂肪肝的价值  

Value and significance of integral backscatter technique combined with serum sirtuin 2-related enzyme 1 and nucleotide-binding oligomerization domain-like receptor protein 3 in the diagnosis of senile hepatic fatty liver

作　　者：王丽敏 董建党[1] 成建华[1] 崔素稳 Wang Limin;Dong Jiandang;Cheng Jianhua;Cui Suwen(Department of Ultrasound,the First People′s Hospital of Shangqiu,Henan 476100,China)

机构地区：[1]河南省商丘市第一人民医院超声科,476100

出　　处：《实用医技杂志》2022年第7期696-702,共7页Journal of Practical Medical Techniques

摘　　要：目的 探究超声背向散射积分(IBS)技术及沉默信息调节因子2相关酶1(Sirt1)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)联合诊断老年肝炎性脂肪肝的价值及意义。方法 选取2016年11月至2018年11月我院收治的142例老年肝炎性脂肪肝患者作为研究组,包含96例乙型肝炎脂肪肝,46例非乙型肝炎脂肪肝,同期纳入134名健康体检者作为正常对照组。比较2组及研究组不同疾病类型、不同脂肪肝程度近场/远场IBS参数[图像平均强度(AII)、图像强度标准差(SDI)、图像峰-峰强度(PPI)]、血清Sirt1、NLRP3水平,绘制受试者工作特征(ROC)曲线分析上述指标单一及联合诊断老年肝炎性脂肪肝价值,采用Pearson分析上述指标与肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、白蛋白、总胆红素(TBIL)]相关性,采用Logistic回归模型分析老年肝炎性脂肪肝的影响因素。结果 研究组近场/远场AII、SDI、PPI及血清NLRP3高于对照组,血清Sirt1水平低于对照组(P<0.05);乙型肝炎脂肪肝患者近场/远场AII、SDI、PPI及血清NLRP3高于非乙型肝炎脂肪肝患者,Sirt1低于非乙型肝炎脂肪肝患者(P<0.05);重度脂肪肝患者近场/远场AII、SDI、PPI及血清NLRP3>中度患者>轻度患者,血清Sirt1水平<中度患者<轻度患者(P<0.05);AII、SDI、PPI、血清Sirt1、NLRP3联合诊断老年肝炎性脂肪肝的曲线下面积(AUC)为0.884,大于各指标单一诊断的AUC,各指标联合的最佳诊断敏感度及特异度分别为77%、90%;老年肝炎性脂肪肝患者AII、SDI、PPI与血清NLRP3间呈正相关,与血清Sirt1间呈负相关(P<0.05);Logistic回归分析显示,控制了年龄、性别、合并症、吸烟及饮酒情况等因素后,肝功能指标、IBS参数、血清Sirt1、NLRP3均是老年肝炎性脂肪肝发生的影响因素(P<0.05)。结论 IBS参数、血清Sirt1、NLRP3联合诊断老年肝炎性脂肪肝的价值较高,有助于临床评估患者肝功能、脂肪肝程�Objective To explore the value and significance of Ultrasound integral backscatter(IBS)technology and sirtuin 2-related enzyme 1(Sirt1),nucleotide-binding oligomerization domain-like receptor protein3(NLRP3)combined diagnosis of senile hepatitis with fatty liver. Methods A total of 142 elderly patients with hepatic fatty liver who were admitted to the First People′s Hospital of Shangqiu from November 2016 to November2018 were selected as the research group,including 96 cases of hepatitis B fatty liver,46 cases of non-hepatitis B fatty liver, during the same period, 134 healthy subjects were included as the normal control group.Comparison of different disease types,the near-field/far-field IBS parameters [mean image intensity(AII),standard deviation of image intensity(SDI),image peak-to-peak intensity(PPI)],serum Sirt1,NLRP3 levels two groups and the study group, receiver operating characteristic(ROC)curve was drawn to analyze the value of the above indicators alone and combined in diagnosing senile hepatic steatosis. Pearson was used to analyze the correlation between the above indicators and liver function indicators [alanine aminotransferase(ALT),aspartate amino-transferase(AST), albumin(ALB), total bilirubin(TBIL)], and Logistic regression model was used to analyze the in-fluencing factors of senile hepatitis with fatty liver. Results The near-field/far-field AII,SDI,PPI and serum NLRP3 in the study group were higher than those in the control group,and the serum Sirt1 level was lower than that in the control group(P <0.05). Near-field/far-field AII, SDI, PPI and serum NLRP3 in patients with HBV fatty liver were higher than those in patients with non-HBV fatty liver,and Sirt1was lower than those in patients with non-HBV fatty liver(P<0.05). Near-field/far-field AII,SDI,PPI and serum NLRP3 in patients with severe fatty liver > moderate patients > mild patients, serum Sirt1 level < moderate patients < mild patients(P<0.05). The area under the curve(AUC)of AII,SDI,PPI,serum Sirt1 and NLRP3for the combined diagno

关 键 词：脂肪肝 超声检查 核蛋白质类 诊断 

分 类 号：R575.5[医药卫生—消化系统]