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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 385 -387. doi: 10.3877/cma.j.issn.1674-3946.2019.04.020

所属专题: 文献

论著

非酒精性脂肪性肝病患者血清肝纤维化指标与肝内脂肪含量的相关性研究
付丽坤1, 盛丽娜1, 邹春燕1, 李京龙1, 谢长顺1, 南月敏1, 李莉1,()   
  1. 1. 066000 河北秦皇岛,秦皇岛市第一医院消化内科
  • 收稿日期:2019-04-10 出版日期:2019-08-26
  • 通信作者: 李莉

Correlation between serum fibrosis markers and intrahepatic fat content in patients with nonalcoholic fatty liver disease

Likun Fu1, Lina Sheng1, Chunyan Zou1, Jinglong Li1, Changshun Xie1, Yuemin Nan1, Li Li1,()   

  1. 1. Department of Gastroenterology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, China
  • Received:2019-04-10 Published:2019-08-26
  • Corresponding author: Li Li
  • About author:
    Corresponding author: Li Li, Email:
  • Supported by:
    Qinhuangdao Science and Technology Bureau Research Project(201703A044); China Hepatitis Prevention Foundation Tianqing Project(TQGB20170122)
引用本文:

付丽坤, 盛丽娜, 邹春燕, 李京龙, 谢长顺, 南月敏, 李莉. 非酒精性脂肪性肝病患者血清肝纤维化指标与肝内脂肪含量的相关性研究[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(04): 385-387.

Likun Fu, Lina Sheng, Chunyan Zou, Jinglong Li, Changshun Xie, Yuemin Nan, Li Li. Correlation between serum fibrosis markers and intrahepatic fat content in patients with nonalcoholic fatty liver disease[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(04): 385-387.

目的

探讨非酒精性脂肪性肝病(NAFLD)患者肝纤维化指标与T1WI同/反相位测定肝内脂肪含量的关系。

方法

选取2017年6~8月非酒精性脂肪性肝病者120例,根据肝纤维化评分(NFS)将患者分为NFS<-1.455亚组(n=35, A组),-1.455≤NFS≤0.676亚组(n=41, B组)及NFS>0.676亚组(n=44, C组)。选择同期体检的年龄、性别、地域相匹配的健康人群50例为对照组,使用SPSS 19.0软件包对数据进行统计分析,肝纤维化指标和肝脏脂肪相对含量用(±s)表示,两两比较采用t检验,多组间比较采用方差分析及Spearman相关分析。P<0.05表示差异有统计学意义。

结果

C组随着血清肝纤维化指标CK18、YKL40、APRI、GPRI的升高,肝内脂肪含量减低,呈负相关关系(r=-0.850、-0.584、-0.784、-0.684, P< 0.05),A组及B组未发现相关关系(P>0.05)。

结论

非酒精性脂肪性肝炎有肝纤维化趋势,肝内脂肪含量与肝纤维化的进展密切相关。

Objective

To investigate the relationship between the liver fibrosis indexes and liver fat content quantitatively detected by in-phase opposed-phase T1WI sequences in patients with nonalcoholic fatty liver disease (NAFLD).

Methods

120 patients with NAFLD from June to August 2017 were selected. According to the NAFLD fibrosis score (NFS), the patients were divided into NFS<-1.455 subgroup (n=35, group A), -1.455≤NFS≤0.676 subgroup (n=41, group B) and NFS>0.676 subgroup (n=44, group C). A total of 50 healthy subjects with matching age, gender and region were selected as the control group. Serum CK18 and YKL40 levels were detected by ELISA, and liver fat content was detected by in-phase opposed-phase T1WI sequences. SPSS 19.0 statistical software was used for data analysis. Liver fibrosis indexes and liver fat relative content were showed as(±s), compared with independent t test. Multiple date sets were compared with Variance and Spearman correlation analysis, P<0.05 indicated the difference was statistically significant.

Results

The values of CK18, YKL40, APRI and GPRI were increased significantly in C group patients, and negative correlation was found (r=-0.850, -0.584, -0.784 and -0.684, P<0.05). The relevance of values of CK18, YKL40, APRI and GPRI and liver fat content in group A and B was not found(P>0.05).

Conclusion

Liver fibrosis trend was found in nonalcoholic steatohepatitis patients, and the liver fat content is closely related to the progression of liver fibrosis.

表1 120例NAFLD患者不同NFS三组血清肝纤维化指标的检测结果(±s)
表2 120例NAFLD患者不同NFS三组血清肝纤维化指标与脂肪相对含量相关性分析(±s)
[1]
Chalasani N, Younossi Z, Lavine JE, et a1.The diagnosis and management of non-alcoholic fatty liver disease:Practice guideline by the American gastroenterological association,American association for the study of liver diseases,and American college of gastroenterology[J].Gastroenterology,2012,142(7):1592-1609.
[2]
Feldstein AE, Gores GJ.Apoptosis in alcoholic and nonalcoholic steatohepatitis[J].Front Biosci,2005,10:3093-3099.
[3]
Bantel H, Bahr MJ, Schulze-Osthoff K.An apoptosis biomarker for prediction of nonalcoholic steatohepatitis[J].Hepatology,2009,50(3):991-991.
[4]
尹栩芳,李振军,施军平.细胞角蛋白18-M30/M65用于中老年脂肪肝筛查的临床价值[J].世界华人消化杂志,2016, 24(9):1444-1448.
[5]
Yilmaz Y, Ulukaya E, Dolar E. Serum M30 levels:a potential biomarker of severe liver disease in nonalcoholic fatty liver disease and normal aminotransferase levels[J]. Hepatology, 2009,49(2):697-697.
[6]
曹欣,关玉娟,陈美娟. 慢性乙型肝炎病毒感染患者血清YKL-40水平与肝纤维化的临床分析[J].肝脏,2016,21(1):57-59.
[7]
刘安楠,赵小兰,陈志恒,等.非酒精性脂肪性肝病患者2054例肝纤维化状况的评估[J].中华全科医师杂志,2017,16(3):219-223.
[8]
王鸣,杨双双,郭威,等.APRI指数对慢性乙型肝炎患者肝纤维化程度的评估价值及临床特征的相关性研究[J].中西医结合肝病杂志,2018,28(5):283-285.
[9]
董菁菁,王允野,刘昆,等. -谷氨酰转肽酶和血小板比值指数对慢性乙型肝炎肝纤维化的诊断价值[J].中华传染病杂志,2017,35(11):670-674.
[10]
Lemoine M, Shimakawa Y, Nayagam S, et al.The gammaglutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa [J].Gut,2016,65(8):1369-1376.
[11]
Lemoine M, Thursz M, Mallet V, et al.Diagnostic accuracy of the gamma-glutamyl transpeptidase to platelet ratio (GPR) using transient elastography as a reference [J].Gut,2017,66(1):195-196.
[12]
Boyd A, Bottero J, Lacombe K.The γ-glutamyl transpeptidase-to-platelet ratio as a predictor of liver fibrosis in patients co-infected with HBV and HIV [J].Gut,2016,65(4):718-720.
[13]
阳宁静,宋彬,唐鹤菡,等. 1H-MRS和MR双回波技术活体半定量评价酒精性脂肪肝大鼠模型[J].磁共振成像,2010,1(3):208-213.
[14]
张安君,耿坚,詹松华,等.梯度回波化学位移MRI诊断非酒精性肝脂肪变性的临床应用[J].医学影像学杂志,2016,26(11):2023-2025.
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