基于二维剪切波弹性成像联合生化指标的列线图模型在中重度代谢相关脂肪性肝病诊断中的应用价值  

Application of Nomogram model based on two-dimensional shear wave elastography combined with biochemical indicators in the diagnosis of moderate and severe metabolic-associated fatty liver disease

作　　者：王坤[1] 汪珺莉 吴艺敏 张宇[1] 许导靖 WANG Kun;WANG Junli;WU Yimin;ZHANG Yu;XU DaoJing(Department of Ultrasound,Wuhu Hospital Affiliated to East China Normal University(the Second People's Hospital of Wuhu),Wuhu 241000,China)

机构地区：[1]华东师范大学附属芜湖医院(芜湖市第二人民医院)超声医学科,安徽芜湖241000

出　　处：《沈阳医学院学报》2025年第1期48-54,共7页Journal of Shenyang Medical College

基　　金：芜湖市卫健委科研项目(No.WHWJ2021y049)。

摘　　要：目的:探讨二维剪切波弹性成像(2D-SWE)联合生化指标的列线图模型诊断中重度代谢相关脂肪性肝病(MAFLD)的临床应用价值。方法:选取2023年1月至12月在我院健康管理中心经超声图像诊断的170例MAFLD患者,根据二维超声图像分为轻、中、重度组,同期招募111例健康志愿者为对照组。采用多因素Logistic回归分析筛选诊断中重度MAFLD的独立危险因素并构建预测模型,绘制受试者工作特征(ROC)曲线分析模型的诊断效能,应用列线图模型进行内部验证。结果:多因素Logistic回归分析结果显示,肝脏硬度值(LSM)、血小板计数(PLT)、肝脏脂肪变性指数(HSI)为诊断中重度MAFLD的独立危险因素。LSM联合PLT、HSI列线图模型曲线下面积(AUC)为0.940 (95%CI:0.911~0.969),灵敏度87.5%,特异度88.1%,内部验证后显示该模型准确性和稳定性较高。结论:基于LSM联合PLT、HSI的列线图模型能有效诊断中重度MAFLD,为临床早期干预和调整治疗措施提供可靠的依据。Objective:To investigate the clinical value of the Nomogram model based on two-dimensional shear wave elastography(2D-SWE)combined with biochemical indicators in the diagnosis of moderate and severe metabolic-associated fatty liver disease(MAFLD).Methods:A total of 170 patients with MAFLD diagnosed by ultrosound image in the health management center of the Second People's Hospital of Wuhu from Jan 2023 to Dec 2023 were divided into mild,moderate and severe groups according to two-dimensional ultrasound images,and 111 healthy volunteers were recruited as control group in the same period.Multivariate logistic regression analysis was used to screen independent risk factors for moderate and severe MAFLD and construct a predictive model.The diagnostic efficacy of the ROC model was plotted,and the Nomogram model was used to conduct internal verification.Results:Multivariate logistic regression analysis showed that liver stiffness measurement(LSM),platelet count(PLT)and hepatic steatosis index(HSI)were the independent risk factors for the diagnosis of moderate and severe MAFLD.The area under the curve(AUC)of LSM,PLT and HSI was 0.940(95%CI:0.911-0.969),with a sensitivity was 87.5%and a specificity was 88.1%.The internal validation showed that the model had high accuracy and stability.Conclusion:The Nomogram model based on LSM combined with PLT and HSI can effectively diagnose moderate and severe MAFLD,providing a reliable evidence for early clinical intervention and adjustment of therapeutic measures.

关 键 词：代谢相关脂肪性肝病 二维剪切波弹性成像 生化指标 列线图 

分 类 号：R575.5[医药卫生—消化系统]