联合血脂、血糖、肝功能及血尿酸检测在诊断老年脂肪肝患者中的价值

目的探究血脂、血糖、肝功能联合血尿酸检测在诊断老年脂肪肝患者中的应用价值。方法 2016年4-11月该院收治的62例老年脂肪肝患者作为研究组,另选取62例同期体检健康者作为对照组。抽取所有研究对象4mL空腹静脉血,速率法检测总胆汁酸(TBA)、γ-谷氨酸转肽酶(GGT)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平;己糖激酶法检测极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)等血脂指标水平;过氧化物酶比色法测定糖化血红蛋白(HbA1c)、空腹血糖(FBG)水平;以深圳迈瑞公司生产的迈瑞BS-400型全自动生化分析仪检测血尿酸水平。对比血脂、血糖、肝功能、血尿酸单独检测与联合检测诊断脂肪肝的性能。结果研究组TBA、GGT、AST、ALT、TBIL水平高于对照组,差异有统计学意义(P0.05);研究组VLDL-C、LDL-C、TC、TG水平高于对照组,HDL-C水平低于对照组,差异有统计学意义(P0.05);研究组HbA1c、FBG水平高于对照组,差异有统计学意义(P0.05);研究组血尿酸水平[(447.12±91.03)μmol/L]高于对照组[(353.41±70.32)μmol/L],差异有统计学意义(P0.05);血脂、血糖、肝功能、血尿酸单独检测对脂肪肝诊断的灵敏度(80.65%、79.03%、82.26%、77.42%)、准确度(90.32%、88.71%、90.32%、88.71%)低于联合检测(95.16%、96.77%),差异有统计学意义(P0.05)。结论脂肪肝患者存在血脂、血糖、肝功能及血尿酸水平异常现象,联合上述指标对脂肪肝进行诊断可提高灵敏度与准确度,为干预方案的制订提供指导依据,值得推广。

The value of the combine detection of blood lipid,blood glucose,liver function and serum uric acid in the diagnosis of elderly patients with fatty liver

Objective To explore the application value of blood lipid,blood glucose,liver function and serum uric acid in the diagnosis of fatty liver in elderly patients.Methods A total of 62 elderly patients with fatty liver in our hospital from April 2016 to October 2016 were selected as study group,and 62 healthy persons were selected as control group.All the subjects were drawn fasting venous blood 4 mL.Rate method was used to detected liver function indexes of total bile acid(TBA),gamma glutamyltranspeptidase(GGT) and aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL) levels.The hexokinase method was used to detected blood lipid indexes,including very low density lipoprotein cholesterol(VLDL-C),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),cholesterol(TC),triglyceride(TG) levels.The peroxidase colorimetric method was used to detected blood glucose index including glycated hemoglobin(HbA1c) and fasting blood glucose(FBG) levels.MINDRAY BS-400 automatic biochemical analyzer produced in Shenzhen MINDRAY company was used to detect the serum uric acid level.Value of blood lipid,blood glucose,liver function,serum uric acid in diagnosis for fatty liver were made statistical comparison.Results The levels of TBA,GGT,AST,ALT and TBIL in the study group were higher than those in the control group,the level of VLDL-C,LDL-C,TG,TC in the study group were higher than those in the control group,the HDL-C level was lower than that in the control group,the levels of FBG and HbA1c in the study group were higher than those in the control group,the level of serum uric acid in the study group[(447.12±91.03)μmol/L] was higher than that in the control group [(353.41±70.32)μmol/L],the differences were all had statistically significant(P<0.05).The sensitivity(80.65%,79.03%,82.26%,77.42%) and accuracy(90.32%,88.71%,90.32%,88.71%) of blood lipids,blood glucose,liver function,blood uric acid alone in diagnosis of fatty liver were lower than the combined diagnosis(95.16%,96.77%),the differences were statistically significant(P<0.05).Conclusion Fatty liver patients have abnormal blood lipids and blood glucose,liver function and blood uric acid level,combined with the above indexes for diagnosis can improve the sensitivity and accuracy of fatty liver,and provide guidance for the intervention,is worthy of promotion.