FibroTouch检测脾脏与肝脏受控衰减参数的相关性及影响因素分析*

doi:10.3969/j.issn.1672-5069.2016.04.015

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (4): 445-450.doi: 10.3969/j.issn.1672-5069.2016.04.015

FibroTouch检测脾脏与肝脏受控衰减参数的相关性及影响因素分析^*

曾静, 陈光榆, 潘勤, 孙婉璐, 顾立飞, 颜士岩, 孙超, 徐正婕, 范建高

200092上海市交通大学医学院附属新华医院消化内科暨脂肪肝诊治中心

收稿日期:2015-12-02 出版日期:2016-07-30 发布日期:2016-08-31
通讯作者: 范建高,E-mail:fattyliver2004@126.com
作者简介:曾静,女,26 岁,医学博士,住院医师。E-mail：littleangel01@126.com
基金资助:
国家973课题（2012CB517501）; 国家自然科学基金资助课题（81070322/81270491）; 上海市科委重点项目（09140903500/10411956300）; 上海市卫生系统优秀学科带头人计划项目（XBR2011007）

Detection of controlled attenuation parameter of spleen in diagnosis of fatty liver diseases

Zeng Jing, Chen Guangyu, Pan Qin, e t al

Department of Gastroenterology,Center for Fatty Liver Disease Study, Xinhua Hospital, Affiliated to JiaoTong University School of Medicine,Shanghai 200092,China

Received:2015-12-02 Online:2016-07-30 Published:2016-08-31

摘要/Abstract

摘要： 目的探讨FibroTouch（FT）检测脾实质厚度>4 cm的慢性肝病患者脾脏与肝脏受控衰减参数（CAP）的相关性,并分析影响检测结果的因素。方法纳入脾实质厚度>4 cm的患者274例。使用FT检测肝脏和脾脏的硬度值和CAP,采用Pearson相关进行相关性分析。结果本组肝脏检测成功率为100%,而脾脏检测成功率为77.4%;274例肝脏和脾脏硬度值分别为（10.07±7.04） kPa和（21.34±19.41） kPa,两者之间存在显著性正相关（r=0.548,P<0.000）;肝脏和脾脏CAP值分别为（235.90±54.40） dB/m和（245.45±66.59） dB/m,两者之间也存在显著正相关（r=0.443,P<0.000）;在BMI<24 kg/m²、24~28 kg/m²、≥28 kg/m²组肝脏CAP值分别为（217.0±45.8）dB/m、（251.6±52.8） dB/m和（299.2±46.0） dB/m,脾脏CAP值分别为（230.4±68.9） dB/m、（261.8±52.8） dB/m和（288.2±41.5） dB/m,两者均随BMI增加有增加趋势（P<0.000）;在皮肤-肝包膜距离（SCD）≤20 mm、20~25 mm、≥25 mm组肝脏CAP值分别为（204.5±26.5） dB/m、（237.9±31.1） dB/m和（268.9±60.7） dB/m,脾脏CAP值分别为（229.8±68.4） dB/m、（262.2±54.3） dB/m和（258.4±60.2） dB/m,显示随着SCD的增加肝脏CAP值也增高（P<0.000）,而在SCD<25 mm与SCD≥25 mm组间脾脏CAP值无显著性差异（P>0.05）;多元回归分析提示BMI是影响肝脏CAP检测的独立因素, 而高密度脂蛋白（HDL）是影响脾脏CAP检测的独立因素。结论 FT可用于有效检测肝脏和脾脏CAP值,通过检测脾脏CAP值以判断肝病的价值还需要进一步研究。

关键词: 脂肪性肝病, FibroTouch, 脾脏, 受控衰减参数, 影响因素

Abstract: Objective This study was aimed to determine the correlation between controlled attenuation parameters（CAPs） of spleen and liver,and investigate the influencing factors in the detections. Methods A total of 274 patients with chronic liver diseases and spleen parenchyma thickness >4 cm were included in this study. We used FibroTouch to measure the stiffness and CAP values of liver and spleen. Then,we tried to find the correlation between liver and spleen measurements by Pearson correlation analysis. Results The success rate of the liver detection was 100%,while the success rate of the spleen detection was 77.37%;The stiffness values of liver and spleen were（10.07±7.04）kPa and （21.34±19.41）kPa respectively,and they were significant correlated （r=0.548,P<0.000） and the CAP values of liver and spleen were（235.90±54.40） dB/m and （245.45±66.59） dB/m respectively,and they had a significant correlation too（r=0.443,P<0.000）;in patients with BMI<24 kg/m²,24~28 kg/m² and≥28 kg/m²,the liver CAP were （217.0±45.8）dB/m,（251.6±52.8）dB/m and （299.2±46.0）dB/m;in patients with skin to liver capsule depth（SCD）≤20 mm,20~25 mm and ≥25 mm,the liver CAP were （204.5±26.5）dB/m,（237.9±31.1）dB/m and （268.9±60.7）dB/m,suggesting they increased with the increase of BMI and SCD; The spleen CAP in each group of BMI<24 kg/m²,24~28 kg/m² and ≥28 kg/m² were （230.4±68.9）dB/m,（261.8±52.8）dB/m and（288.2±41.5）dB/m;Liver CAP in each group of SCD≤20 mm,20~25 mm and≥25 mm were （229.8±68.4）dB/m,（262.2±54.3）dB/m and（258.4±60.2）dB/m,suggesting they increased with the increase of BMI,but had no significant difference in the group of SCD<25 mm and SCD≥25 mm;The multivariate linear regression showed that BMI was the independent factor of liver CAP,while high-density lipoprotein was the independent factor of spleen CAP. Conclusion FT can be used to detect the liver CAP in almost all and spleen CAP in most of patients with chronic liver diseases,and the application of the latter in diagnosis of liver diseases needs to further investigation.

Key words: Fatty liver diseases, FibroTouch, Spleen, Controlled attenuation parameter, Influencing factors

曾静, 陈光榆, 潘勤, 孙婉璐, 顾立飞, 颜士岩, 孙超, 徐正婕, 范建高. FibroTouch检测脾脏与肝脏受控衰减参数的相关性及影响因素分析^*[J]. 实用肝脏病杂志, 2016, 19(4): 445-450.

Zeng Jing, Chen Guangyu, Pan Qin, e t al. Detection of controlled attenuation parameter of spleen in diagnosis of fatty liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(4): 445-450.

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FibroTouch检测脾脏与肝脏受控衰减参数的相关性及影响因素分析^*

Detection of controlled attenuation parameter of spleen in diagnosis of fatty liver diseases

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