Fibroscan评估非酒精性脂肪性肝病患者肝脏脂肪变性程度应用研究*

doi:10.3969/j.issn.1672-5069.2026.03.007

摘要/Abstract

摘要： 目的分析Fibroscan技术评估非酒精性脂肪性肝病(NAFLD)患者肝脏脂肪变性程度的价值。方法 2022年7月～2024年12月我院收治的NAFLD患者115例,接受Fibroscan检查受控衰减参数(CAP)和肝脏硬度检测(LSM),所有患者接受肝活检。采用ELISA法检测血清细胞角蛋白18 M30片段,应用受试者工作特征曲线评估诊断效能。结果在本组115例NAFLD患者中,肝组织学检查发现S0级5例,S1级21例,S2级46例和S3级43例;S3级患者血清CK 18-M30水平为(145.6±27.3)U/L,显著高于S2级【(123.7±25.2)U/L,P＜0.05】或S0～S1级【(100.1±24.5)U/L,P＜0.05】;S3级患者血清总胆固醇、甘油三酯和低密度脂蛋白水平显著高于,而血清高密度脂蛋白水平显著低于S0～S1级或S2级(P＜0.05);S3组肝脏CAP和LSM分别为(332.8±30.1)dB/m和(8.5±1.3)kPa,显著高于S2级【分别为(298.9±31.5)dB/m和(6.8±1.4)kPa,P＜0.05】或S0～S1级【分别为(252.1±9.7)dB/m和(5.7±0.9)kPa,P＜0.05】;CAP诊断中重度(>或=S2)肝脂肪变的AUC为0.890,其敏感性为84%,特异性为74%,显著优于血清CK 18-M30诊断(其AUC为0.620,敏感性为78%,特异性为46%)。结论使用Fibroscan技术检测CAP能够较准确地评估NAFLD患者肝脏脂肪变性程度,为临床早期干预提供依据。

关键词: 非酒精性脂肪性肝病, 受控衰减参数, 细胞角蛋白18 M30, 诊断

Abstract: Objective The aim of this study was to investigate diagnostic performance of Fibroscan in evaluating hepatic steatosis in patients with non alcoholic fatty liver diseases (NAFLD). Methods A total of 115 patients with NAFLD were encountered in our hospital between July 2022 and December 2024, and all underwent liver biopsies and Fibroscan for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Serum cytokeratin 18 M30 fragment (CK 18-M30) level were detected by ELISA. Receiver operating characteristic curve (ROC) was applied to assess diagnostic efficacy. Results Of the 115 patients with NAFLD in our series, liver pathological examination found hepatic steatosis S0 in 5 cases, S1 in 21 cases, S2 in 46 cases and S3 in 43 cases; serum CK 18-M30 level in S3 group was (145.6±27.3)U/L, much higher than [(123.7±25.2)U/L, P＜0.05] in S 2 group or [(100.1±24.5)U/L, P＜0.05] in S0-S1 group; serum total cholesterol, triglycerides and low-density lipoprotein levels in patients with S3 were much higher, while high-density lipoprotein level was much lower than in patients with S0-S1 or S2 group(P＜0.05); CAP and LSM in S3 group were (332.8±30.1)dB/m and (8.5±1.3)kPa, significantly higher than [(298.9±31.5)dB/m and (6.8±1.4)kPa, respectively, P＜0.05] in S2 group or [(252.1±9.7)dB/m and (5.7±0.9)kPa, respectively, P＜0.05] in S0-S1 group; the AUC was 0.890, with sensitivity (Se) of 84% and specificity (Sp) of 74%, when CAP was applied to evaluate equal to or greater than S2 liver steatosis, much superior to serum CK 18-M30 did (the AUC was 0.620, Se of 78% and Sp of 46%). Conclusion The CAP obtained by Fibroscan scan could accurately stratify liver steatosis in patients with NAFLD, and merits further clinical verification.

Key words: Nonalcoholic fatty liver disease, Liver steatosis, Controlled attenuation parameters, Diagnosis

赵迎娣, 陈钰婷, 宗富强. Fibroscan评估非酒精性脂肪性肝病患者肝脏脂肪变性程度应用研究^*[J]. 实用肝脏病杂志, 2026, 29(3): 345-348.

Zhao Yingdi, Chen Yuting, Zong Fuqiang. Application of Fibroscan in evaluating hepatic steatosis in patients with non alcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2026, 29(3): 345-348.

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Fibroscan评估非酒精性脂肪性肝病患者肝脏脂肪变性程度应用研究^*

Application of Fibroscan in evaluating hepatic steatosis in patients with non alcoholic fatty liver diseases

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