超声声衰减成像定量参数联合RC/HDL-C诊断MAFLD肝脂肪变程度的效能及与脂代谢的相关性  

Diagnostic value of ultrasound attenuation imaging parameters combined with residual cholesterol/HDL-C in assessing hepatic steatosis of MAFLD and its correlation with lipid metabolism

作　　者：胡丽军 连倩倩 HU Li-jun;LIAN Qian-qian(Department of Ultrasound,Handan People's Hospital,Hebei 056001,China;Department of Function,Cheng'an County Hospital in Handan City,Hebei 056700,China)

机构地区：[1]邯郸市人民医院超声科,河北056001 [2]邯郸市成安县医院功能科,056700

出　　处：《肝脏》2024年第10期1260-1264,共5页Chinese Hepatology

基　　金：河北省卫健委科技研究计划基金项目(20201516)。

摘　　要：目的探讨超声声衰减成像定量参数联合残余胆固醇/高密度脂蛋白胆固醇(residual cholesterol/high-density lipoprotein cholesterol,RC/HDL-C)诊断代谢相关脂肪性肝病(MAFLD)肝脂肪变程度的效能及与脂代谢的相关性。方法回顾性分析2021年1月至2023年12月于邯郸市人民医院接受检查的146例MAFLD患者的临床资料,根据MAFLD肝脂肪变程度分为轻度组、中度组、重度组,比较各组间声衰减系数(attenuation coefficient,AC)、RC/HDL-C水平,分析AC与RC/HDL-C的相关性,以及MAFLD肝脂肪变程度的影响因素,评估AC、RC/HDL-C对MAFLD肝脂肪变程度的诊断效能。结果146例MAFLD患者中,肝脂肪变轻度36例(24.66%)、中度58例(39.73%)、重度52例(35.62%)。轻度组、中度组、重度组患者的AC分别为(0.71±0.22)、(0.80±0.25)、(0.93±0.28)dB/(cm·MHz),RC/HDL-C分别为(0.18±0.04)、(0.22±0.05)、(0.23±0.07),差异有统计学意义(P<0.05)。AC(OR=3.677,95%CI:1.085~12.453)、RC/HDL-C(OR=4.133,95%CI:1.221~13.998)是MAFLD患者中重度肝脂肪变程度的危险因素(P<0.05)。AC、RC/HDL-C单一及联合诊断中重度肝脂肪变程度的灵敏度分别为0.61、0.68、0.77,特异度分别为0.87、0.79、0.87,曲线下面积分别为0.736、0.738、0.829。结论AC、RC/HDL-C可用于MAFLD肝脂肪变程度的辅助诊断,且诊断效能良好。Objective To evaluate the diagnostic accuracy of quantitative ultrasound attenuation imaging parameters combined with the Residual Cholesterol/High-Density Lipoprotein Cholesterol(RC/HDL-C)ratio,in detecting hepatic steotosis in patients with metabolic dysfunction-associated fatty liver disease(MAFLD).Additionally,to investigate the correlation between these parameters and lipid metabolism in the context of liver fat infiltration.Methods A retrospective analysis was performed on the medical records of 146 patients with MAFLD who were examined at the People's Hospital of Handan City from January 2021 to December 2023 in.Based on the degree of hepatic steatosis,patients were categorized into mild,moderate,and severe groups.Differences in attenuation coefficient(AC),and RC/HDL-C levels among these groups were compared.The correlation between AC and RC/HDL-C was analyzed,and factors influencing liver fat infiltration in MAFLD were evaluated.Additionally,the diagnostic efficacy of AC and RC/HDL-C in assessing the severity of hepatic steatosis in MAFLD was examined.Results Among the 146 patients with MAFLD,36 cases(24.66%)had mild hepatic steatosis,58 cases(39.73%)had moderate steatosis,and 52 cases(35.62%)had severe steatosis.The AC for the mild,moderate,and severe groups were(0.71±0.22)dB cm-1 MHz-1,(0.80±0.25)dB cm^(-1)MHz^(-1),and(0.93±0.28)dB cm^(-1)MHz^(-1),respectively.The RC/HDL-C ratios were(0.18±0.04),(0.22±0.05),and(0.23±0.07),respectively.The differences were statistically significant(P<0.05).Both AC(OR=3.677,95%CI:1.085-12.453)and RC/HDL-C(OR=4.133,95%CI:1.221-13.998)were identidied as risk factors for the severity of hepatic steatosis in MAFLD patients(P<0.05).The sensitivity and specificity for diagnosing moderate to severe liver steatosis using AC,RC/HDL-C,and their combination were 0.61,0.68,and 0.77,respectively,with corresponding area under the curve(AUC)values of 0.736,0.738,and 0.829.Conclusion AC,RC/HDL-C can serve as auxiliary diagnostic tools for assessing the degree of hepatic steatosis i

关 键 词：代谢相关脂肪性肝病 肝脂肪变程度 超声声衰减成像 超声声衰减系数 残余胆固醇/高密度脂蛋白胆固醇 诊断效能 

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]