实用肝脏病杂志2024，Vol.27Issue(1)：44-47,4.DOI:10.3969/j.issn.1672-5069.2024.01.012
超声衰减参数联合血清PAI-1和ALT水平评估代谢相关脂肪性肝病患者肝脂肪变性程度的价值分析
Application of ultrasound attenuation parameter combined with serum PAI-1 and ALT levels in evaluating severe hepatic steatosis in patients with metabolic associated fatty liver diseases
摘要
Abstract
Objective This study was conducted to investigate the diagnostic performance of ultrasound attenuation parameter(UAP)combined with serum plasminogen activator inhibitor-1(PAI-1)and alanine aminotransaminase(ALT)levels in evaluating severe hepatic steatosis in patients with metabolic associated fatty liver disease(MAFLD).Methods 112 patients with MAFLD were admitted to our hospital between March 2019 an December 2022,and all patients underwent liver biopsy and transient elastography for UAP detection.Serum PAI-1 level was measured by ELISA.The diagnostic efficacy was analyzed by using the receiver operating characteristic(ROC)curve.Results Out of the 112 patients with MAFLD,the liver histopathological examination showed mild liver steatosis in 45 cases,moderate in 42 cases and severe in 25 cases;the BMI,serum TC,TG and LDL-C levels in patients with severe liver steatosis were(32.6±2.4)kg/m2,(6.6±0.9)mmol/L,(4.6±1.4)mmol/L and(4.0±0.9)mmol/L,significantly higher than[(27.6±1.9)kg/m2,(5.8±0.8)mmol/L,(3.5±0.9)mmol/L and(3.5±0.7)mmol/L,respectively,P<0.05]in patients with moderate or[(24.1±0.9)kg/m2,(5.1±0.7)mmol/L,(2.2±0.7)mmol/L and(3.0±0.5)mmol/L,respectively,P<0.05]in mild,while serum HDL-C level was(1.2±0.2)mmol/L,significantly lower than[(1.4±0.2)mmol/L,P<0.05]in moderate or[(1.4±0.2)mmol/L,P<0.05]in mild liver steatosis;the UAP,serum PAI-1 and ALT level in patients with severe steatosis were(312.7±32.6)dB/m,(36.5±4.2)mg/mL and(72.1±7.4)U/L,much higher than[(284.2±30.1)dB/m,(28.1±3.4)mg/mL and(36.3±4.1)U/L,P<0.05]in moderate or[(257.4±26.4)dB/m,(20.4±2.4)mg/mL and(23.7±2.5)U/L,P<0.05]in mild steatosis;the ROC analysis showed that the AUC,sensitivity(Se)and specificity(Sp)were 0.914(95%CI:0.883-0.990),89.6%and 93.3%,with the Sp superior to any single parameter evaluation(P<0.05)by the combination of UAP and serum PAI-1 and ALT level in predicting severe liver steatosis.Conclusion We recommend the combination of UAP and serum PAI-1 and ALT level in predicting severe hepatic steatosis in patients with MAFLD,which might provide a scientific clue for clinical management.关键词
代谢相关脂肪性肝病/肝脂肪变性/超声衰减参数/纤溶酶原激活物抑制物1/丙氨酸氨基转移酶/诊断Key words
Metabolic associated fatty liver diseases/Liver steatosis/Ultrasound attenuation parameter/Plasminogen activator inhibitor 1/Alanine aminotransaminase/Diagnosis引用本文复制引用
叶茜,郑东,杨昕宇,郭江,符美茵,谢燕华,刘洪..超声衰减参数联合血清PAI-1和ALT水平评估代谢相关脂肪性肝病患者肝脂肪变性程度的价值分析[J].实用肝脏病杂志,2024,27(1):44-47,4.基金项目
达州市科技局科研计划项目(编号:20YYJC0005) （编号:20YYJC0005）
