FibroTouch检测参数诊断非酒精性脂肪性肝炎患者效能分析*

doi:10.3969/j.issn.1672-5069.2025.01.016

摘要/Abstract

摘要： 目的探讨FibroTouch检测参数诊断非酒精性脂肪性肝炎(NASH)的效能。方法 2022年3月～2023年3月我院诊治的149例非酒精性脂肪性肝病(NAFLD)患者,均接受肝活检,使用FibroTouch行肝脏硬度检测(LSM)和受控衰减参数(CAP)。应用多因素Logistics回归分析影响NASH发生的因素,绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC),评估指标的诊断效能。结果经组织病理学检查,在本组149例NAFLD患者中,发现NASH患者45例(30.2%)和单纯性脂肪肝(SFL)患者104例(69.8%);NASH组体质指数(BMI)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和低密度脂蛋白水平分别为(29.7±1.8)kg/m²、(82.6±25.7)U/L、(107.4±10.5)U/L、(74.2±16.0)U/L、(65.6±11.1)U/L和(4.2±0.9)mmol/L,均显著高于SFL组【分别为(25.6±1.5)kg/m²、(50.3±19.4)U/L、(82.5±8.5)U/L、(28.9±15.2)U/L、(21.2±12.4)U/L和(3.1±0.8)mmol/L,P<0.05】;NASH组CAP和LSM分别为(304.0±19.6)db/m和(13.1±2.1)kPa,均显著大于SFL组【分别为(263.9±15.4)db/m和(8.2±1.6)kPa,P＜0.05】;多因素Logistics逐步回归分析显示CAP和LSM是NASH发生的独立影响因素(P＜0.05);以CAP等于303.7 db/m和LSM等于12.9 kPa为截断点,其联合诊断NASH的AUC为0.901,敏感度为96.8%,特异度为82.5%。结论联合应用CAP和LSM在NAFLD人群中筛选NASH有很大的参考意义,可为临床处理提供重要的依据。

关键词: 非酒精性脂肪性肝病, 非酒精性脂肪性肝炎, 单纯性脂肪肝, 受控衰减参数, 肝脏硬度检测, 诊断

Abstract: Objective The aim of this study was to explore diagnostic performance of FibroTouch parameters in the diagnosis of non-alcoholic steatohepatitis (NASH) from individuals with non-alcoholic fatty liver diseases (NAFLD). Methods 149 patients with NAFLD were encountered in our hospital between March 2022 and March 2023, and all underwent liver biopsies. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were obtained by FibroTouch detection. Multivariate Logistic regression analysis was applied to find risk factors, and the area under the receiver operating characteristic curve (AUC) was used to analyze diagnostic efficacy of above parameters for NASH occurrence. Results Histo-pathological examination diagnosed NASH in 45 cases (30.2%) and simple fatty liver (SFL) in 104 cases (69.8%) in our series; body mass index (BMI), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and low density lipoprotein levels in patients with NASH were (29.7±1.8)kg/m², (82.6±25.7)U/L, (107.4±10.5)U/L, (74.2±16.0)U/L, (65.6±11.1)U/L and (4.2±0.9)mmol/L, all significantly higher than【 (25.6±1.5)kg/m², (50.3±19.4)U/L, (82.5±8.5)U/L, (28.9±15.2)U/L, (21.2±12.4)U/L and (3.1±0.8)mmol/L, respectively, P<0.05] in patients with SFL; CAP and LSM in NASH patients were (304.0±19.6)db/m and (13.1±2.1)kPa, both much higher than [(263.9±15.4)db/m and (8.2±1.6)kPa, respectively, P＜0.05] in SFL patients; multivariate Logistics regression analysis showed that CAP and LSM were independent risk factors for NASH occurrence (P＜0.05); the AUC was 0.901, with sensitivity of 96.8% and specificity of 82.5%, when CAP=303.7 db/m and LSM=12.9 kPa were set as cut-off-value in predicting NASH existence in individuals with NAFLD. Conclusion FibroTouch-detected LSM and CAP could help screen NASH preliminarily in individuals with NAFLD, which might guide appropriate management in clinical practice.

Key words: Non-alcoholic steatohepatitis, Non-alcoholic fatty liver diseases, Simple fatty liver, Controlled attenuation parameter, Liver stiffness measurement, Diagnosis

沈玥, 朱宁, 王海. FibroTouch检测参数诊断非酒精性脂肪性肝炎患者效能分析^*[J]. 实用肝脏病杂志, 2025, 28(1): 60-63.

Shen Yue, Zhu Ning, Wang Hai. Diagnostic performance of FibroTouch parameters in the diagnosis of non-alcoholic steatohepatitis[J]. Journal of Practical Hepatology, 2025, 28(1): 60-63.

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FibroTouch检测参数诊断非酒精性脂肪性肝炎患者效能分析^*

Diagnostic performance of FibroTouch parameters in the diagnosis of non-alcoholic steatohepatitis

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