全血铁对非酒精性脂肪性肝病患者肝纤维化的诊断价值  

Diagnostic value of whole blood iron levels in liver fibrosis in patients with non-alcoholic fatty liver disease

作　　者：林淳 黎华 LIN Chun;LI Hua(Department of Laboratory,Liwan Central Hospital of Guangzhou,Guangzhou 510370,China)

机构地区：[1]广州市荔湾中心医院检验科,510370

出　　处：《国际消化病杂志》2025年第1期44-48,共5页International Journal of Digestive Diseases

摘　　要：目的探究全血铁对非酒精性脂肪性肝病(NAFLD)患者肝纤维化的诊断价值。方法选择2021年6月至2024年1月于广州市荔湾中心医院(原广州市荔湾区人民医院)就诊的100例NAFLD患者作为研究对象,其中肝纤维化患者40例(设为肝纤维化组),无肝纤维化患者60例(设为无肝纤维化组)。收集入组患者的临床资料,检测入院时全血铁、铜、锌、钙、镁水平,以及肝纤维化指标Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)和透明质酸(HA)水平。采用Pearson相关性分析评估NAFLD患者全血铁与肝纤维化指标的相关性。采用ROC曲线分析全血铁和肝纤维化指标对NAFLD患者肝纤维化的诊断效能。结果与无肝纤维化组相比,肝纤维化组的BMI、ALT、AST、GGT、总胆红素(TBil)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、PCⅢ、CⅣ、LN、HA及全血铁水平均显著升高,差异均有统计学意义(P均<0.05);而2组的全血铜、锌、钙、镁水平差异均无统计学意义(P均>0.05)。Pearson相关性分析结果显示,NAFLD患者的全血铁与血清PCⅢ、CⅣ、LN、HA均呈正相关(P均<0.05)。ROC曲线分析结果显示,PCⅢ、CⅣ、LN、HA和全血铁诊断NAFLD患者发生肝纤维化的曲线下面积(AUC)分别为0.70、0.74、0.73、0.76和0.77。全血铁与4项肝纤维化指标联合检测诊断NAFLD患者发生肝纤维化的AUC大于4项肝纤维化指标联合检测(0.89比0.88)。结论NAFLD合并肝纤维化患者的全血铁水平升高,且全血铁与肝纤维化指标呈显著正相关。全血铁与肝纤维化指标联合检测在NAFLD合并肝纤维化患者的诊断中具有较高的应用价值。Objective This paper investigates the diagnostic value of whole blood iron levels in liver fibrosis among patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 100 NAFLD patients treated at Liwan Central Hospital of Guangzhou(Original:Guangzhou Liwan District People's Hospital)between June 2021 and January 2024 were selected as the study subjects,including 40 patients with liver fibrosis(liver fibrosis group)and 60 patients without liver fibrosis(non-liver fibrosis group).Clinical data were collected,including whole blood iron,copper,zinc,calcium and magnesium levels,as well as liver fibrosis indexes such as typeⅢprocollagen(PCⅢ),typeⅣcollagen(CⅣ),laminin(LN)and hyaluronic acid(HA)levels were detected at admission.Pearson correlation analysis was performed to evaluate relationships between whole blood iron levels and liver fibrosis markers.ROC curve analysis was used to assess the diagnostic efficacy of these biomarkers in patients with NAFLD.Results Compared to the non-liver fibrosis group,the liver fibrosis group shows significantly higher BMI,ALT,AST,GGT,TBil,TG,HDL-C,PCⅢ,CⅣ,LN,HA,and whole blood iron levels(P<0.05).No significant differences are found in whole blood copper,zinc,calcium,and magnesium between the 2 groups(P>0.05).Pearson correlation analysis shows a positive correlation whole blood iron and serum levels of PCⅢ,CⅣ,LN,and HA in NAFLD patients(P<0.05).ROC curve analysis reveals that the area under the curve(AUC)for diagnosing liver fibrosis in NAFLD patients was 0.70,0.74,0.73,0.76 and 0.77 for PCⅢ,CⅣ,LN,and HA for whole blood iron,respectively.The combination of whole blood iron and the four fibrosis markers results in a higher AUC for diagnosing liver fibrosis(0.89)compared to the combination of the four fibrosis markers alone(0.88).Conclusions Whole blood iron levels are increased in NAFLD patients with liver fibrosis,and a significant positive correlation exists between whole blood iron and liver fibrosis makers.The combined detection of whole blood iron

关 键 词：非酒精性脂肪性肝病 全血铁 肝纤维化 

分 类 号：R575.5[医药卫生—消化系统] R575.2[医药卫生—内科学]