瞬时弹性成像技术联合血清游离脂肪酸对非酒精性脂肪性肝病的诊断价值  

Diagnostic Value of iLiv Touch Combined with Serum Free Fatty Acid in Non-Alcoholic Fatty Liver Disease

作　　者：杨文帅 王立坤[3] 董聪慧 武永萍 石栓柱 YANG Wenshuai;WANG Likun;DONG Conghui;WU Yongping;SHI Shuanzhu(Department of Ultrasound,Zhangjiakou Infectious Disease Hospital,Zhangjiakou,Heibei 075000,China;Department of Hepatology,Zhangjiakou Infectious Disease Hospital,Zhangjiakou,Hebei 075000,China;Department of Ultrasound Diagnosis,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北省张家口市传染病医院超声科,河北张家口075000 [2]河北省张家口市传染病医院肝病科,河北张家口075000 [3]河北北方学院附属第一医院超声诊断科,河北张家口075000

出　　处：《转化医学杂志》2024年第9期1330-1335,共6页Translational Medicine Journal

基　　金：2022年河北省医学科学研究课题计划(20220028);2023年张家口市科技局科技计划项目(2322030D)。

摘　　要：目的探讨iLiv Touch瞬时弹性成像技术联合血清游离脂肪酸(FFA)对非酒精性脂肪性肝病(NAFLD)的诊断价值。方法选取2018年6月至2019年12月在河北省张家口市传染病医院进行肝脏病理学、iLiv Touch检查的107例NAFLD患者进行研究,根据脂肪变性程度分为S0组(35例)、S1组(25例)、S2组(27例)、S3组(20例),采用酶比色法检测血清FFA水平,并进行组间比较;iLiv Touch检测脂肪衰减参数(FAP);绘制受试者工作特征(ROC)曲线评估血清FFA对NAFLD(S≥1)、NAFLD(S≥2)、NAFLD(S≥3)的诊断价值;iLiv Touch、FFA结果中任一项或一项以上为脂肪变性,联合检查结果判为脂肪变性,以病理学诊断结果为金标准,分别评估iLiv Touch及其联合FFA对NAFLD(≥1)、NAFLD(S≥2)、NAFLD(S≥3)的诊断价值。结果与S0组相比,S1组、S2组、S3组FAP、FFA均较高(P<0.05);与S1组相比,S2组、S3组FAP、FFA均较高(P<0.05);与S2组相比,S3组FAP、FFA均较高(P<0.05)。iLiv Touch单独诊断NAFLD(S≥1)、NAFLD(S≥2)、NAFLD(S≥3)的灵敏度、特异度、准确度分别为85.71%、77.78%、80.37%,88.33%、85.11%、86.92%,93.10%、75.00%、89.72%;血清FFA单独诊断NAFLD(S≥1)、NAFLD(S≥2)、NAFLD(S≥3)的曲线下面积(AUC)分别为0.869、0.920、0.836,截断值分别为0.70mmol/L、0.89mmol/L、1.13 mmol/L,灵敏度、特异度、准确度分别为74.29%、83.33%、80.37%,71.67%、93.62%、81.31%,81.61%、75.00%、80.37%;i Liv Touch联合血清FFA诊断NAFLD(S≥1)、NAFLD(S≥2)、NAFLD(S≥3)的灵敏度、特异度、准确度分别为91.43%、70.83%、77.57%,93.33%、72.34%、87.85%,95.40%、70.00%、90.65%,均较单独诊断敏感度高。结论iLiv Touch瞬时弹性成像技术联合血清FFA诊断NAFLD较两者单独诊断敏感度高,且可用于分度诊断,可为NAFLD的随访及病情监测提供临床参考依据。Objective To investigate the diagnostic value of iLiv Touch combined with serum free fatty acid(FFA)in non-alcoholic fatty liver disease(NAFLD).Methods A total of 107 patients with liver pathology and iLiv Touch examination in our hospital from June 2018 to December 2019 were selected and divided into four subgroups according to steatosis severity:S0 group(35 cases),S1 group(25 cases),S2 group(27 cases),S3 group(20 cases).The serum FFA level was detected by enzyme colorimetry and compared between groups;fat attenuation parameters(FAP)were detected by iLiv Touch.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum FFA for NAFLD(S≥1),NAFLD(S≥2),and NAFLD(S≥3).If either or both iLiv Touch and FFA results indicated steatosis,the combined diagnostic results were considered positive.Pathological diagnosis served as the gold standard to assess the diagnostic value of iLiv Touch and FFA in NAFLD(S≥1),NAFLD(S≥2),and NAFLD(S≥3).Results Compared with the S0 group,FAP and FFA of S1 group,S2 group,and S3 group were higher(P<0.05);compared with the S1 group,FAP and FFA of S2 group and S3 group were higher(P<0.05);compared with the S2 group,FAP and FFA of S3 group were higher(P<0.05).The sensitivity,specificity,and accuracy of iLiv Touch in the diagnosis of NAFLD(S≥1),NAFLD(S≥2),and NAFLD(S≥3)were 85.71%,77.78%,and 80.37%;88.33%,85.11%,and 86.92%;93.10%,75.00%,and 89.72%,respectively.The area under the curve(AUC)of serum FFA in the diagnosis of NAFLD(S≥1),NAFLD(S≥2),and NAFLD(S≥3)were 0.869,0.920,and 0.836;the cut-off values were 0.70 mmol/L,0.89 mmol/L,and 1.13 mmol/L,respectively.The sensitivity,specificity,and accuracy for FFA alone were 74.29%,83.33%,and 80.37%;71.67%,93.62%,and 81.31%;81.61%,75.00%,and 80.37%,respectively.The sensitivity,specificity,and accuracy of iLiv Touch combined with serum FFA for diagnosing NAFLD(S≥1),NAFLD(S≥2),and NAFLD(S≥3)were 91.43%,70.83%,and 77.57%;93.33%,72.34%,and 87.85%;95.40%,70.00%,and 90.65%,respectively,all of

关 键 词：非酒精性脂肪性肝病 瞬时弹性成像技术 脂肪衰减参数 游离脂肪酸 ROC曲线 

分 类 号：R575.5[医药卫生—消化系统]