非均匀性脂肪肝患者腹部超声表现和血脂变化特点*

目的 分析非均匀性脂肪肝患者肝脏超声和血生化指标变化特点。方法 2016年1月～2018年12月我院诊断的非酒精性非均匀性脂肪肝患者90例和同期在我院体检的健康者30例,均行超声检查和血生化指标检测。结果 在90例患者中,I型(局部浸润型) 23例(25.6%),II型(叶段浸润型)29例(32.2%),III型(弥漫性非均匀浸润型)38例(42.2%);II型组血清转铁蛋白(SF)为(254.2±98.7)μg/L,显著高于健康人【(175.1±98.4)μg/L,P<0.05】,III型组血清空腹血糖水平为(6.37±0.79)mmol/L,显著高于健康人【(4.85±0.53)mmol/L,P<0.05】,糖化血红蛋白水平为(6.94±0.81)%,显著高于健康人【(4.73±0.57)%,P<0.05】,尿酸水平为(418.3±40.5)μmol/L,显著高于健康人【(354.2±37.8)μmol/L,P<0.05】,SF为(287.3±105.1)μg/L,显著高于健康人【(175.1±98.4)μg/L,P<0.05】;II型血清谷草转氨酶(AST)水平为(51.5±13.4)IU/L,显著高于健康人【(24.2±9.3)IU/L,P<0.05】,谷胺酰转肽酶(GGT)水平为(59.3±31.2)IU/L,显著高于健康人【(29.8±10.1)IU/L,P<0.05】,III型组血清胆固醇水平为(4.7±0.8)mmol/L,显著高于健康人【(3.8±0.6)mmol/L,P<0.05】,甘油三酯水平为(3.2±1.5)mmol/L,显著高于健康人【(1.4±0.3)mmol/L,P<0.05】,AST为(60.2±18.7)IU/L,显著高于健康人【(24.2±9.3)IU/L,P<0.05】,谷丙转氨酶水平为(54.2±29.8)IU/L,显著高于健康人【(30.2±13.4)IU/L,P<0.05】,GGT为(59.3±31.2)IU/L,显著高于健康人【(29.8±10.1)IU/L,P<0.05】。结论 超声检查非均匀性脂肪肝诊断准确,能鉴别出轻度脂肪浸润或局限性的脂肪浸润肝组织,结合血生化指标检测,能为脂肪肝的临床诊断提供参考依据。

Ultrasonographic and biochemical features of patients with non-alcoholic heterogeneous fatty liver

Objective The aim of this study was to summarize the ultrasonographic and biochemical features of patients with non-alcoholic heterogeneous fatty liver(NAHFL).Methods 90 patients with NAHFL and 30 healthy persons were enrolled in our hospital between January 2016 and December 2018,and ultrasonography and blood biochemical indicators were carried out.Results Out of the 90 patients with NAHFL,23 cases(25.6%)belonged to typeⅠ(local invasive type),29 cases(32.2%)belonged to typeⅡ(segmental infiltration type)and 38 cases(42.2%)belonged to typeⅢ(diffuse heterogeneous infiltration)type);serum transferrin(SF)level in patients with typeⅡfatty liver was(254.2±98.7)μg/L,significantly higher than(175.1±98.4)μg/L,P<0.05]in healthy control;the fasting blood glucose level in patients with typeⅢfatty liver was(6.37±0.79)mmol/L,significantly higher P<0.05]in the control,and HbA1c was than(4.85±0.53)mmol/L,(6.94±0.81)%,significantly higher than(4.73±0.57)%,P<0.05]in the control,blood uric acid level was(418.3±40.5)μmol/L,significantly higher than(354.2±37.8)μmol/L,P<0.05]in the control,and SF was(287.3±105.1)mg/l,significantly higher than(175.1±98.4)μg/L,P<0.05]in the control;serum AST level in patients with typeⅡfatty liver was(51.5±13.4)IU/L,significantly higher than(24.2±9.3)IU/L,P<0.05]in the control,serum GGT level was(59.3±31.2)IU/L,significantly higher than(29.8±10.1)IU/L,P<0.05]in the control,blood TC in patients with typeⅢfatty liver was(4.7±0.8)mmol/L,significantly higher than(3.8±0.6)mmol/L,P<0.05]in the control,blood TG was(3.2±1.5)mmol/L,significantly higher than(1.4±0.3)mmol/L,P<0.05]in the control,serum AST was(60.2±18.7)IU/L,significantly higher than(24.2±9.3)IU/L,P<0.05],serum ALT was(54.2±29.8)IU/L,significantly higher than(30.2±13.4)IU/L,P<0.05],and serum GGT level was(59.3±31.2)IU/L,significantly higher than(29.8±10.1)IU/L,P<0.05]in the control.Conclusion Ultrasonography might show a characteristic features in patients with NAHFL,and the diagnosis might be made at the base of blood analysis in clinical practice.