目的 通过声触诊组织定量技术(VTQ)定量评价非酒精性脂肪肝(NAFLD),研究VTQ技术对NAFLD的诊断价值.方法 选择2014年6月至2016年6月安徽医科大学第二附属医院收治的NAFLD患者108例,按照常规超声检查结果分为轻度组、中度组和重度组,每组36例,同时选择36例同期非肝病患者作为对照组.测量上述各组肝左叶S4段、肝右叶S5段横向剪切波速度(SWV),同时测量腹直肌及皮下脂肪厚度.对3组NAFLD患者进行非药物性干预12个月,比较干预前后SWV值、腹直肌及皮下脂肪厚度的变化.结果 干预前,4组对象肝脏S4、S5段SWV值分别为:对照组(0.90±0.11)m/s、(1.10±0.09)m/s,轻度组(1.01±0.19)m/s、(1.03±0.22)m/s,中度组(1.16±0.17)m/s、(1.21±0.18)m/s,重度组(1.25±0.20)m/s、(1.34±0.13)m/s.4组对象各测量指标间的组间差异均有统计学意义(P<0.05).再将3组NAFLD患者的各测量指标分别与对照组比较,SWV值的差异均有统计学意义(P<0.05),且随脂肪肝严重程度的增加差异更加明显;而腹直肌及皮下脂肪厚度的比较,仅重度脂肪肝组与对照组比较差异有统计学意义(P<0.05).进行非药物干预后,轻、中、重3组NAFLD患者的肝S4段、S5段的SWV测值分别为:(0.81±0.11)m/s、(0.83±0.24)m/s,(0.98±0.17)m/s、(1.01±0.18)m/s,(0.96±0.20)m/s、(0.99±0.13)m/s,与干预前比较均有所降低,差异有统计学意义(P<0.05).结论 采用VTQ技术评价NAFLD具有较高的诊断价值,并且可以定量诊断,因此具有很好的临床应用价值,值得推广.%Objective To study the application of VTQ in the diagnosis of patients with NAFLD.Methods From June 2014 to June 2016, 108 patients with NAFLD were selected as the research object. According to the routine ultrasound examination results, all patients were divided into mild group, moderate group and severe group, with 36 cases in each group. Another 36 cases of non liver disease patients in the hospital were selected as the control group. We measured the SWV values of S4 and S5 segments, the subcutaneous?fat?thickness,and the thickness of the abdominal rectus muscle. All values were compared before and after intervention.Results Before intervention, the SWV values of S4 and S5 segments in four groups were: the control group (0.90±0.11)m/s, (1.10±0.09)m/s; the mild group (1.01±0.19)m/s, (1.03±0.22)m/s; the moderate goup (1.16±0.17)m/s, (1.21±0.18)m/s; the severe group (1.25±0.20)m/s, (1.34±0.13)m/s. All values were statistically significant among the four groups (P<0.05). Then the three NAFLD groups were compared with the control group respectively, values ofSWV were statistically significant (P<0.05), and there were serious statistical significance in severe group. But the other two values were statistically significant only between the control group and severe group (P<0.05). After intervention, the three NAFLD groups’ SWV values of S4 and S5 segmentswere: the mild group 0.81±0.11m/s, 0.83±0.24m/s; the moderate group (0.96±0.20)m/s, (0.99±0.13)m/s; the severe group (0.98±0.17)m/s, (1.01±0.18)m/s. Before and after intervention, the SWV values were statistically significant among the three NAFLD groups(P<0.05). Conclusion The application of VTQ in the diagnosis of NAFLD has great potential clinical application value.
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