高频超声所测肝脾指数对非酒精性脂肪肝分级诊断的多中心研究  

Multicenter study on high-frequency ultrasound measurement of hepatosplenic index for grading diagnosis of non-alcoholic fatty liver disease

作　　者：祁航 周洪雨[2] 邓家琦 孟繁坤[4] 吴晓莉 卢强[1] 向虹瑾 经翔[2] 罗燕[1] QI Hang;ZHOU Hongyu;DENG Jiaqi;MENG Fankun;WU Xiaoi;LU Qiang;XIANG Hongjin;JING Xiang;LUO Yan(Department of Ultrasound Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院超声医学科,成都市610041 [2]天津市第三中心医院超声科 [3]西南医科大学附属医院超声科 [4]首都医科大学附属北京佑安医院超声科 [5]攀枝花中心医院超声科

出　　处：《临床超声医学杂志》2024年第4期285-290,共6页Journal of Clinical Ultrasound in Medicine

基　　金：中国医学科学院临床与转化医学研究基金项目(2022-I2M-C&T-B-105)。

摘　　要：目的应用高频超声测量肝脾指数(HSI),探讨其在非酒精性脂肪肝分级诊断中的临床价值。方法回顾性纳入5所医院共233例肝脏疾病患者,均经手术或肝脏穿刺获得脂肪肝病理分级结果,并据此分为正常者27例(正常组)、轻度脂肪肝者77例(轻度组)、中度脂肪肝者83例(中度组)、重度脂肪肝者46例(重度组)。所有患者均于获得病理结果前14 d内进行超声检查测量HSI,比较各组HSI和临床资料的差异。采用多元线性回归分析HSI与各临床资料及肝脏脂肪变性程度的相关性;绘制受试者工作特征(ROC)曲线分析HSI对不同程度肝脏脂肪变性的诊断效能。结果轻度组、中度组、重度组及正常组年龄、天冬氨酸氨基转移酶、白蛋白、总胆固醇、低密度脂蛋白、甘油三酯比较,差异均有统计学意义(均P<0.05)。正常组、轻度组、中度组、重度组HSI分别为1.04±0.09、1.11±0.14、1.22±0.13、1.33±0.17,各组两两比较差异均有统计学意义(均P<0.05)。相关性分析显示,HSI与肝脏脂肪变性程度呈线性正相关(β=0.115,P<0.001)。ROC曲线分析显示,HSI诊断有无肝脏脂肪变性、中度及以上肝脏脂肪变性、重度肝脏脂肪变性的曲线下面积分别为0.84、0.86、0.80,截断值分别为1.13、1.16、1.24,灵敏度和特异度分别为60.2%、82.0%、78.3%和92.3%、92.4%、86.6%。结论高频超声所测HSI在非酒精性脂肪肝分级诊断中有重要的临床价值。Objective To measure the hepatosplenic index(HSI)by high-frequency ultrasound,and to explore its clinical value in the grading diagnosis of non-alcoholic fatty liver.Methods Totally 233 patients with liver disease from five hospitals were included retrospectively,all of whom underwent surgery or liver biopsy to obtain pathological grading of fatty liver.according to the pathological results,the patients were divided into 27 normal cases(normal group),77 mild fatty liver cases(mild group),83 moderate fatty liver cases(moderate group),46 severe fatty liver cases(severe group).All patients underwent ultrasonography within 14 d before the pathological results obtained.The differences of HSI and clinical data among the groups were compared.Multiple linear regression analysis was used to analyze the correlation between HSI and clinical data as well as the degree of fatty degeneration.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic performance of HSI for different degrees of fatty degeneration.Results The differences in age,aspartic transaminase,albumin,total cholesterol,low density lipoprotein,and triglyceride among the mild,moderate,severe groups,and the normal group were statistically significant(all P<0.05).The HSI in the normal group,mild group,moderate group,and severe group were 1.04±0.09,1.11±0.14,1.22±0.13 and 1.33±0.17,respectively,and there were statistically significant differences in pairwise(all P<0.05).Correlation analysis showed that HSI was linearly positively correlated with the degree of fatty degeneration(β=0.115,P<0.001).ROC curve analysis showed that the area under the curve for HSI in diagnosing the presence or absence of fatty liver,moderate-to-severe fatty liver,and severe fatty liver were 0.84,0.86 and 0.80,respectively.The cutoff value were 1.13,1.16 and 1.24,the sensitivity and specificity were 60.2%,82.0%,78.3%and 92.3%92.4%,86.6%,respectively.Conclusion HSI measured by high-frequency ultrasound has important clinical value in the grading di

关 键 词：超声检查 非酒精性脂肪肝 分级诊断 肝脾指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.5[医药卫生—诊断学]