CAJ | 학술논문

目的探讨血清降钙素原(PCT)和C反应蛋白(CRP)在非酒精性脂肪任肝病(NAFLD)中的诊断意义.方法 50例NAFLD患者和50例健康对照者纳入研究,所有受试者检测肝功能、肝脏超声、体质指数,并通过稳态模型评估胰岛素抵抗.血清PCT检测采用全自动快速定量法,CRP检测应用散射比浊法.结果 50例NAFLD患者中有20例诊断为脂肪性肝炎,27例为弥漫性脂肪肝,3例局灶型脂肪肝. 非酒精性脂肪性肝炎(NASH)和非酒精性单纯性脂肪肝(NAFL)的血清PCT水平相似,与对照组相比差异无统计学意义(P＞0.05).CRP水平在NAFL和NASH中都有明显升高,两者之间差异无统计学意义,但与对照组相比差异均有统计学意义[(7.5±1.6)、(5.2±2.5)比(2.9 ±0.5)mg/L,P＜0.01].结论血清PCT对NAFL和NASH没有诊断价值.NAFLD患者的血CRP水平明显升高,可以用作NAFLD的附加诊断指标,但是不能区分NAFL和NASH.
목적 탐토혈청강개소원(PCT)화C반응단백(CRP)재비주정성지방임간병(NAFLD)중적진단의의.방법 50례NAFLD환자화50례건강대조자납입연구,소유수시자검측간공능、간장초성、체질지수,병통과은태모형평고이도소저항.혈청PCT검측채용전자동쾌속정량법,CRP검측응용산사비탁법.결과 50례NAFLD환자중유20례진단위지방성간염,27례위미만성지방간,3례국조형지방간. 비주정성지방성간염(NASH)화비주정성단순성지방간(NAFL)적혈청PCT수평상사,여대조조상비차이무통계학의의(P＞0.05).CRP수평재NAFL화NASH중도유명현승고,량자지간차이무통계학의의,단여대조조상비차이균유통계학의의[(7.5±1.6)、(5.2±2.5)비(2.9 ±0.5)mg/L,P＜0.01].결론 혈청PCT대NAFL화NASH몰유진단개치.NAFLD환자적혈CRP수평명현승고,가이용작NAFLD적부가진단지표,단시불능구분NAFL화NASH.
Objective To study the diagnostic and discriminative role of serum procalcitonin (PCT) and C reactive protein (CRP) in non-alcoholic fatty liver diseases (NAFLD).Methods Fifty NAFLD cases and 50 healthy controls were included to the study.Liver function tests were measured,body mass index was calculated,and insulin resistance was determined by using a homeostasis model assessment (HOMA-IR).Ultrasound evaluation was performed for each subject.Serum CRP was measured with nephalometric method.Serum PCT was measured with Kryptor based system.Results Among 50 cases of NAFLD,20 patients were fatty hepatitis,27 cases were diffuse fatty liver,3 cases were focal fatty liver.Serum PCT levels were similar in nonalcholic steatohepatitis (NASH,n =20) and nonalcholic simple fatty liver (NAFL,n =27) patients,and there were no significant different compared with the control group.Serum CRP levels were significantly higher in NAFL and NASH groups compared to healthy controls (7.5 ± 1.6 and 5.2 ± 2.5 vs 2.9 ± 0.5 mg/L respectively,P ＜ 0.01).Beside,three patients with focal fatty liver disease had normal serum CRP and PCT levels.Conclusions Serum PCT is within normal ranges in patients with NAFL or NASH and has no diagnostic value.Serum CRP level increases in NAFLD compared to controls.CRP can be used as an additional marker for diagnosis of NAFLD but it has no value in discrimination of NASH from NAFL.