FibroTouch检测脾脏与肝脏受控衰减参数的相关性及影响因素分析*

目的 探讨FibroTouch（FT）检测脾实质厚度>4 cm的慢性肝病患者脾脏与肝脏受控衰减参数（CAP）的相关性,并分析影响检测结果的因素。方法 纳入脾实质厚度>4 cm的患者274例。使用FT检测肝脏和脾脏的硬度值和CAP,采用Pearson相关进行相关性分析。结果 本组肝脏检测成功率为100%,而脾脏检测成功率为77.4%;274例肝脏和脾脏硬度值分别为（10.07±7.04） kPa和（21.34±19.41） kPa,两者之间存在显著性正相关（r=0.548,P<0.000）;肝脏和脾脏CAP值分别为（235.90±54.40） dB/m和（245.45±66.59） dB/m,两者之间也存在显著正相关（r=0.443,P<0.000）;在BMI<24 kg/m²、24~28 kg/m²、≥28 kg/m²组肝脏CAP值分别为（217.0±45.8）dB/m、（251.6±52.8） dB/m和（299.2±46.0） dB/m,脾脏CAP值分别为（230.4±68.9） dB/m、（261.8±52.8） dB/m和（288.2±41.5） dB/m,两者均随BMI增加有增加趋势（P<0.000）;在皮肤-肝包膜距离（SCD）≤20 mm、20~25 mm、≥25 mm组肝脏CAP值分别为（204.5±26.5） dB/m、（237.9±31.1） dB/m和（268.9±60.7） dB/m,脾脏CAP值分别为（229.8±68.4） dB/m、（262.2±54.3） dB/m和（258.4±60.2） dB/m,显示随着SCD的增加肝脏CAP值也增高（P<0.000）,而在SCD<25 mm与SCD≥25 mm组间脾脏CAP值无显著性差异（P>0.05）;多元回归分析提示BMI是影响肝脏CAP检测的独立因素, 而高密度脂蛋白（HDL）是影响脾脏CAP检测的独立因素。结论 FT可用于有效检测肝脏和脾脏CAP值,通过检测脾脏CAP值以判断肝病的价值还需要进一步研究。

Detection of controlled attenuation parameter of spleen in diagnosis of fatty liver diseases

Objective This study was aimed to determine the correlation between controlled attenuation parameters（CAPs） of spleen and liver,and investigate the influencing factors in the detections. Methods A total of 274 patients with chronic liver diseases and spleen parenchyma thickness >4 cm were included in this study. We used FibroTouch to measure the stiffness and CAP values of liver and spleen. Then,we tried to find the correlation between liver and spleen measurements by Pearson correlation analysis. Results The success rate of the liver detection was 100%,while the success rate of the spleen detection was 77.37%;The stiffness values of liver and spleen were（10.07±7.04）kPa and （21.34±19.41）kPa respectively,and they were significant correlated （r=0.548,P<0.000） and the CAP values of liver and spleen were（235.90±54.40） dB/m and （245.45±66.59） dB/m respectively,and they had a significant correlation too（r=0.443,P<0.000）;in patients with BMI<24 kg/m²,24~28 kg/m² and≥28 kg/m²,the liver CAP were （217.0±45.8）dB/m,（251.6±52.8）dB/m and （299.2±46.0）dB/m;in patients with skin to liver capsule depth（SCD）≤20 mm,20~25 mm and ≥25 mm,the liver CAP were （204.5±26.5）dB/m,（237.9±31.1）dB/m and （268.9±60.7）dB/m,suggesting they increased with the increase of BMI and SCD; The spleen CAP in each group of BMI<24 kg/m²,24~28 kg/m² and ≥28 kg/m² were （230.4±68.9）dB/m,（261.8±52.8）dB/m and（288.2±41.5）dB/m;Liver CAP in each group of SCD≤20 mm,20~25 mm and≥25 mm were （229.8±68.4）dB/m,（262.2±54.3）dB/m and（258.4±60.2）dB/m,suggesting they increased with the increase of BMI,but had no significant difference in the group of SCD<25 mm and SCD≥25 mm;The multivariate linear regression showed that BMI was the independent factor of liver CAP,while high-density lipoprotein was the independent factor of spleen CAP. Conclusion FT can be used to detect the liver CAP in almost all and spleen CAP in most of patients with chronic liver diseases,and the application of the latter in diagnosis of liver diseases needs to further investigation.