超声联合弹性成像炎症活动度相关A指数在诊断非酒精性脂肪性肝炎中的价值  

The value of ultrasound combinational elastography inflammation activity-related A index in diagnosing non-alcoholic steatohepatitis

作　　者：陈洁[1] 张波[1,2,3] 周彪 马姣姣[1] 席雪华 孙脉 卢潇 CHEN Jie;ZHANG Bo;ZHOU Biao(Department of Ultrasound,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院超声医学科,北京100029 [2]中日友好医院国家呼吸医学中心、国家呼吸临床研究中心、中国医学科学院呼吸病学研究院,北京100029 [3]中国医学科学院北京协和医学院,北京100730 [4]中日友好医院普通外科代谢减重中心,北京100029

出　　处：《中日友好医院学报》2024年第4期195-198,共4页Journal of China-Japan Friendship Hospital

基　　金：中日友好医院高水平医院临床业务费专项资助(2023-NHLHCRF-YYPPLC-TJ-18)。

摘　　要：目的:探索超声联合弹性成像炎症活动度相关A指数对非酒精性脂肪性肝炎(NASH)的诊断效能。方法:回顾分析代谢减重中心2020年10月—2021年4月住院患者的临床基线、超声联合弹性成像A指数、实验室检查和肝脏组织病理学数据。比较NASH组和非NASH组的临床特征及实验室检查。以病理诊断为金标准,分析NASH组和非NASH组A指数的差异,绘制受试者操作特征曲线,探索A指数对于NASH的诊断效能。结果:纳入研究的53名患者中,NASH组有18例,非NASH组35例,平均年龄34.8±9.3岁。平均体重指数(BMI)为37.0±5.5kg/m^(2)。A指数的中位数为1.02,范围0.62~1.33。NASH组和非NASH组A指数比较,差异有统计学意义(P=0.000)。A指数诊断NASH的曲线下面积(AUC)为0.889。临界值为1.035时,诊断的灵敏度为0.722,特异度为0.800。结论:联合弹性成像炎症活动度相关A指数能够较好地鉴别非酒精性脂肪肝病中的单纯性脂肪肝和NASH,具有较高的临床应用价值。Objective:To evaluate the diagnostic efficacy of ultrasound combinational elastography A index related to inflammation activity for non-alcoholic steatohepatitis(NASH).Methods:Clinical baseline,combinational elastography activity-related A index,laboratory tests,and liver histopathological data of inpatients at Department of General Surgery&Obesity and Metabolic Disease Center in China-Japan Friendship Hospital were retrospectively analyzed.Clinical characteristics and laboratory tests were compared between the NASH and non-NASH groups.The difference in A index between the NASH and non-NASH groups was analyzed using pathological diagnosis as the gold standard.Receiver operating characteristic curves were plotted to explore the diagnostic efficacy of the A index for NASH.Results:Among the 53 patients included in the study,there were 18 cases in the NASH group and 35 cases in the non-NASH group,with a mean age of 34.8±9.3 years.The mean body mass index(BMI)was 37.0±5.5g/m^(2),and the A index was 1.00±0.13(range 0.62~1.33).The median of the A index was 1.02,ranging from 0.62 to 1.33.There was a statistically significant difference in the A index between the NASH group and the non-NASH group(P=0.000).The area under the curve(AUC)of the A index for diagnosing NASH was 0.889.When the critical value was 1.035,the sensitivity and specificity of the diagnosis were 0.722 and 0.800,respectively.Conclusion:The combination of elastography and inflammation activity related A-index can effectively distinguish between simple fatty liver and NASH in non-alcoholic fatty liver disease,and has high clinical application value.

关 键 词：联合弹性成像 A指数 非酒精性脂肪性肝炎 非酒精性脂肪肝病 

分 类 号：R575.5[医药卫生—消化系统]