FibroTouch® 脂肪衰减参数对非酒精性脂肪性肝病患者肝脏脂肪变程度的诊断价值*

doi:10.3969/j.issn.1672-5069.2016.01.013

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (1): 50-54.doi: 10.3969/j.issn.1672-5069.2016.01.013

FibroTouch^®脂肪衰减参数对非酒精性脂肪性肝病患者肝脏脂肪变程度的诊断价值*

杨硕, 吕栋, 王天懿, 张龙友, 徐有青

100050 北京市首都医科大学附属北京天坛医院消化内科（杨硕,吕栋,王天懿,徐有青）,体检科（张龙友）

收稿日期:2015-05-18 出版日期:2016-01-10 发布日期:2016-02-04
通讯作者: 徐有青,E-mail：youqingxu@gmail.com
作者简介:杨硕,女,25岁,硕士研究生。主要从事肝脏疾病的临床研究。E-mail:yangshuo_0619@126.com
基金资助:
*基金项目：北京市医院管理局临床医学发展专项经费资助项目（编号：XM201308）

Diagnostic efficacy of FibroTouchR by measuring fat attenuation index in detecting liver steatosis in patients with non-alcoholic fatty liver diseases

Yang Shuo, Lyu Dong, Wang Tianyi, Zhang Longyou, Xu Youqing

Department of Gastroenterology,Tiantan Hospital,Capital Medical University,Beijing 100050,China

Received:2015-05-18 Online:2016-01-10 Published:2016-02-04

摘要/Abstract

摘要： 目的评价FibroTouch^® 脂肪衰减参数对非酒精性脂肪性肝病（NAFLD）患者肝脏脂肪变程度的诊断价值。方法纳入NAFLD患者86例和健康人90例,根据肝脏B超结果进行肝脏脂肪变分度（轻度43例、中度28例和重度15例）。使用FibroTouch^® 检查进行脂肪衰减参数和肝脏硬度值检测。构建受试者工作特征（ROC）曲线,计算曲线下面积（AUC）,确定脂肪衰减参数对轻、中、重度肝脏脂肪变的诊断截断点,计算敏感度和特异度。结果健康人与NAFLD患者BMI分别为[（22.9±2.1） kg/m²和（27.8±3.4） kg/m²,P<0.001],脂肪衰减为[（215.1±16.3） db/m和（263.0±25.1） db/m,P<0.001],肝脏硬度为[（5.1±1.1） Kpa和（8.8±5.7） Kpa,P<0.001];轻度、中度和重度脂肪肝患者脂肪衰减分别为[（244.0±9.9） db/m、（273.8±9.7） db/m和（301.9±20.1） db/m,P<0.001];脂肪衰减与BMI（r=0.741,P<0.001）和肝脏硬度（r=0.442,P<0.001）呈正相关;脂肪衰减诊断轻度、中度和重度脂肪肝的AUC分别为0.935、0.986和0.969（P<0.001）,其对应的诊断截断点分别为237 db/m（敏感度96.7%,特异度86.4%）、259 db/m（敏感度97.7%,特异度92.9%）和286 db/m（敏感度96.4%,特异度93.3%）。结论FibroTouchR 脂肪衰减参数可以无创、快速、客观地诊断NAFLD患者的肝脏脂肪变程度。

关键词: 非酒精性脂肪性肝病, FibroTouch®, 脂肪衰减参数, 肝脏脂肪变

Abstract: Objective To evaluate the diagnostic value of FibroTouch^® by fat attenuation index（FAI） in patients with non-alcoholic fatty liver diseases（NAFLD）. Methods A total of 86 patients with NAFLD and 90 healthy persons were recruited in this study. NAFLD group was divided into mild,moderate and severe liver steatosis based on B-ultrasonography. Two independent sample t-test was used to compare body mass index （BMI）,FAI and liver stiffness were obtained by FibroTouch^® between NAFLD group and healthy control. One-way analysis of variance was used to compare above parameters among mild,moderate and severe liver steatosis. Pearson correlation was used to analyze the relationship between FAI and BMI or liver stiffness. Receiver operating characteristic（ROC） curves were plotted,and the areas under the curves（AUC） were calculated. The cut-off values were defined by maximizing the sum of sensitivity and specificity（maximum Youden index）. Results Between control group and NAFLD group,BMI were [（22.9±2.1） kg/m² and （27.8±3.4） kg/m²,P<0.001],FAI were [（215.1±16.3） db/m and （263.0±25.1） db/m,P<0.001],liver stiffness were [（5.1±1.1） Kpa and （8.8±5.7） Kpa,P<0.001];Among mild（n=43）,moderate（n=28）,severe（n=15） liver steatosis,FAI showed significant difference [（244.0±9.9） db/m,（273.8±9.7） db/m and（301.9±20.1） db/m,P<0.001];FAI showed positive correlation with BMI （r=0.741,P<0.001） and liver stiffness （r=0.442,P<0.001）;AUC of normal vs. mild,mild vs. moderate, and moderate vs. severe were（0.935,0.986,and 0.969,respectively,P<0.001）;The cut-off values for mild, moderate,and severe liver steatosis were 237 db/m（sensitivity 96.7%, specificity 86.4%）,259 db/m （se. 97.7%, sp. 92.9%）,and 286 db/m（ se. 96.4%,sp. 93.3%）,respectively. Conclusion FAI shows advantages in diagnosing NAFLD,and has a promising diagnostic potential for grading liver steatosis in patients with NAFLD.

Key words: Non-alcoholic fatty liver diseases, FibroTouch®, Fat attenuation index, Liver steatosis

杨硕, 吕栋, 王天懿, 张龙友, 徐有青. FibroTouch^®脂肪衰减参数对非酒精性脂肪性肝病患者肝脏脂肪变程度的诊断价值*[J]. 实用肝脏病杂志, 2016, 19(1): 50-54.

Yang Shuo, Lyu Dong, Wang Tianyi, Zhang Longyou, Xu Youqing. Diagnostic efficacy of FibroTouchR by measuring fat attenuation index in detecting liver steatosis in patients with non-alcoholic fatty liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(1): 50-54.

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FibroTouch^®脂肪衰减参数对非酒精性脂肪性肝病患者肝脏脂肪变程度的诊断价值*

Diagnostic efficacy of FibroTouchR by measuring fat attenuation index in detecting liver steatosis in patients with non-alcoholic fatty liver diseases

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