CAJ | 학술논문

目的筛选和寻找脂肪肝分级诊断的最佳预测指标.方法 45只健康新西兰大白兔,采用高脂高糖饲料加酒精饮料建立不同程度脂肪肝模型,应用肉眼观测、血生化、超声、计算机断层扫描(CT)及氢磁共振波谱(1H MRS)多种临床诊断手段,观测22个指标并进行对照研究.结果在所选择的22个观测指标中,肝脏湿重、肝脏指数、肝CT值、肝/腰大肌密度比率、1H MRS脂肪峰值、脂肪波峰下面积、脂/水波峰下面积比率、脂肪百分比、超声衰减系数、谷草转氨酶(AST)、血清胆固醇(CHOL)、三酰甘油(TG)等12个指标总体均数存在组间差异性,且与脂肪肝分级具有显著性相关,其中肝脏指数、肝CT值和血清胆固醇为脂肪肝分级诊断的最佳预测指标,相关系数分别为0.709,-0.764,0.886,判断脂肪肝分级的回归方程Y=1.975+3.906×10-2X1+0.369X2-2.84×10-2X3,Y:脂肪肝分级,X1:血清胆固醇,X2:肝脏指数,X3:肝CT值.结论联合应用多种诊断手段,综合考虑多个最佳预测指标的诊断方法 ,能够为临床快速、准确地判断脂肪肝程度提供帮助.
목적 사선화심조지방간분급진단적최가예측지표.방법 45지건강신서란대백토,채용고지고당사료가주정음료건립불동정도지방간모형,응용육안관측、혈생화、초성、계산궤단층소묘(CT)급경자공진파보(1H MRS)다충림상진단수단,관측22개지표병진행대조연구.결과 재소선택적22개관측지표중,간장습중、간장지수、간CT치、간/요대기밀도비솔、1H MRS지방봉치、지방파봉하면적、지/수파봉하면적비솔、지방백분비、초성쇠감계수、곡초전안매(AST)、혈청담고순(CHOL)、삼선감유(TG)등12개지표총체균수존재조간차이성,차여지방간분급구유현저성상관,기중간장지수、간CT치화혈청담고순위지방간분급진단적최가예측지표,상관계수분별위0.709,-0.764,0.886,판단지방간분급적회귀방정Y=1.975+3.906×10-2X1+0.369X2-2.84×10-2X3,Y:지방간분급,X1:혈청담고순,X2:간장지수,X3:간CT치.결론 연합응용다충진단수단,종합고필다개최가예측지표적진단방법 ,능구위림상쾌속、준학지판단지방간정도제공방조.
Objective To select the most powerful predictors for the evaluation of hepatic steatosis grade. Methods Forty-five healthy New Zealand rabbits were randomly divided into normal control and three experimental groups. Hepatic steatosis models were established by giving high fat, high sugar diet with drinking water containing five percent ethanol. Twenty-two variable indexes were measured with general observation, biochemical indexes, Ultrasonography, CT, 1H MRS. Results By statistical analysis, there were twelve variable indexes with significant differences among groups and correlated with hepatic steatosis grade, they were liver weight, hepatic index, liver CT value, liver-muscle density ratio, 1H MRS fat peak value, fat peak area, fat-water peak area ratio, fat percent, ultrasound attenuation coefficient, serum AST, CHOL, TRIG. Among them hepatic index, liver CT value and serum CHOL were selected as the most powerful predictors for hepatic steatosis grade, correlation coefficients were 0.709, -0.764, 0.886, respectively, regression equation was Y=1.975+3.906×10-2X1+0.369X2-2.84×10-2X3, Y: hepatic steatosis grade, X1: serum CHOL, X2: hepatic index, X3: liver CT value. Conclusion Combined application of the several diagnostic methods is hopeful to improve the rapid, accurate evaluation grade of fatty liver.