CAJ | 학술논문

目的：研究血清铁蛋白（SF）对非酒精性脂肪肝（NAFLD）患者早期肝纤维化的诊断价值。方法随机选取104例NAFLD患者和60例健康人进行血清学、肝脏B超和SF检查。NAFLD患者行肝脏活组织检查。分析并评价SF对NAFLD患者早期肝纤维化的诊断价值。结果 NAFLD患者的丙氨酸氨基转移酶（ALT ）、γ‐谷氨酰转移酶（GGT）、总胆固醇（TC）、三酰甘油（TG）、透明质酸（HA）、层黏连蛋白（LN）、Ⅲ型前胶原氨基端肽（PⅢNP）、Ⅳ型胶原（CⅣ）、SF均高于健康对照组，差异有统计学意义（P＜0．05）。0期肝纤维化患者的 HA、CⅣ和SF小于早期患者，差异有统计学意义（P＜0．05）。在早期患者中，相关性分析显示 SF水平与 HA、C Ⅳ呈正相关（rHA ＝0．44，rCⅣ＝0．53，P＜0．05）。ROC 曲线发现 SF对早期肝纤维化患者的诊断曲线下面积为0．688（P＝0．005），当SF为93μg／L时，诊断的灵敏度为73％，特异性为67％。结论血清SF的升高能够反映NAFLD患者早期肝纤维化的变化，有望成为NAFLD早期肝纤维化的血清学辅助诊断指标。
목적：연구혈청철단백（SF）대비주정성지방간（NAFLD）환자조기간섬유화적진단개치。방법수궤선취104례NAFLD환자화60례건강인진행혈청학、간장B초화SF검사。NAFLD환자행간장활조직검사。분석병평개SF대NAFLD환자조기간섬유화적진단개치。결과 NAFLD환자적병안산안기전이매（ALT ）、γ‐곡안선전이매（GGT）、총담고순（TC）、삼선감유（TG）、투명질산（HA）、층점련단백（LN）、Ⅲ형전효원안기단태（PⅢNP）、Ⅳ형효원（CⅣ）、SF균고우건강대조조，차이유통계학의의（P＜0．05）。0기간섬유화환자적 HA、CⅣ화SF소우조기환자，차이유통계학의의（P＜0．05）。재조기환자중，상관성분석현시 SF수평여 HA、C Ⅳ정정상관（rHA ＝0．44，rCⅣ＝0．53，P＜0．05）。ROC 곡선발현 SF대조기간섬유화환자적진단곡선하면적위0．688（P＝0．005），당SF위93μg／L시，진단적령민도위73％，특이성위67％。결론혈청SF적승고능구반영NAFLD환자조기간섬유화적변화，유망성위NAFLD조기간섬유화적혈청학보조진단지표。
Objective To evaluate the clinical value of serum ferritin (SF) in diagnosis for hepatic fibrosis in patients with nonalcoholic fatty liver disease(NAFLD) .Methods One hundred and four NAFLD patients and sixty healthy controls were enrolled in this study .Serum routine test ,hepatic ultrasonography and serum ferritin for all participants were assessed and liver biopsy were performed for NAFLD patients .Results The levels of alanine amin‐otransferase (ALT) ,gamma glutamine transferase(GGT) ,total cholesterol (TC) ,triacylglycerol (TG) ,hyaluronic acid (HA) ,laminin(LN) ,Procollagen Ⅲ N‐terminal peptide(PⅢNP) ,Collagen Type Ⅳ (CⅣ)and SF in NAFLD pa‐tients were significantly higher than those of healthy controls (P<0 .05) .The levels of HA ,CⅣ and SF in fibrosis stage 0 patients were lower than the early stage patients (P<0 .05) .SF was positive correlated with HA andC Ⅳ by Spearman analysis (rHA =0 .44 ,rCⅣ =0 .53 ,P<0 .05) .The area under curve (AUC) of receiver operating character‐istic (ROC) of SF was 0 .688 .When the SF level was 93 μg/L ,the sensitivity and specificity of SF were 73% and 67% respectively .Conclusion Serum levels of ferritin is positively correlated with the severity of liver fibrosis ,which would be a promising biomarker for early fibrosis patients with NAFLD .