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目的探究剪切波定量(Elast PQ)技术联合生化指标对酒精性脂肪肝(AFL)的临床诊断效果及相关性。方法选取30例AFL患者设为研究组,并选取同时期的30例健康人员设为对照组。均使用Elast PQ技术检查肝脏硬度,并应用全自动生化分析仪采集部分生化指标,分析各检测指标与Elast PQ值的相关性,通过ROC曲线确定AFL的诊断界值。结果研究组Elast PQ值低于对照组,差异具有统计学意义(P<0.05)。研究组谷氨酰转肽酶(GGT)水平高于对照组,天门冬氨酸转移酶(AST)/丙氨酸转移酶(ALT)低于对照组,差异具有统计学意义(P<0.05)。在研究组中Elast PQ可指示不同硬度的脂肪肝病变情况。研究组GGT、AST/ALT与肝脏Elast PQ值呈正相关性(r=0.65、0.57,P<0.05);对照组GGt、AST/ALT与elast PQ值无明显相关性(P>0.05)。研究组ROC曲线下最大面积为(0.85±0.03),面积标准误差为0.02,置信区间为95%(0.82、0.94)。当Elast PQ值=3.67 k Pa有最高特异性和敏感度,分别为67%、85%。结论 Elast PQ技术联合代谢指标能够准确判定AFL,且结果敏感度高、准确度高,应于临床重点推广。
Objective To investigate the clinical diagnostic value and correlation of Elast PQ combined with biochemical markers in patients with alcoholic fatty liver (AFL). Methods Thirty patients with AFL were selected as the study group, and 30 healthy individuals in the same period were selected as the control group. Elast PQ technique was used to check the liver stiffness. Some biochemical indexes were collected by automatic biochemical analyzer. The correlation between each index and Elast PQ value was analyzed. The diagnostic cutoff value of AFL was determined by ROC curve. Results The Elast PQ value of the study group was lower than that of the control group, the difference was statistically significant (P <0.05). The level of glutamyltranspeptidase (GGT) in the study group was higher than that in the control group, while the level of AST / ALT was lower than that in the control group (P <0.05) . Elast PQ in the study group may indicate lesions of fatty liver with different hardness. There was a positive correlation between GGT, AST / ALT and liver Elast PQ in study group (r = 0.65,0.57, P <0.05). There was no significant correlation between GGt, AST / ALT and elast PQ in control group (P> 0.05). The maximum area under the ROC curve of the study group was (0.85 ± 0.03), the area standard error was 0.02, and the confidence interval was 95% (0.82,0.94). When Elast PQ value = 3.67 k Pa has the highest specificity and sensitivity, respectively, 67%, 85%. Conclusion Elast PQ combined with metabolic indices can accurately determine the AFL, and the results of high sensitivity and accuracy, should be the clinical focus of promotion.