| Objective:To explore the clinical application value of transient elastography(Fibro Touch)Fat Attenuation Index(FAI value) in the diagnosis of Nonalcoholic simple fatty liver(NAFL),research the correlation between the FAI value and TCM syndrome types of NAFL,the consistency of levels of fatty liver ultrasound,and other indicators,in orde r to enrich the objective indicator of TCM syndrome differentiation.Methods:Collect 150 patients of NAFL from February 2014 to February 2015 in the second people’s hospital medical center and digestive internal medicine clinic in fu jian province.Collect all patients’ clinical data:name,sex,age,body mass index (BMI),liver function(ALT、AST),blood lipid(TG、TC),fasting plasma glucose(FPG) and so on;Ado pt FibroTouch to detect FAI value of NAFL,Colordoppler ultrasonic diagnostic apparat us in the diagnosis of fatty liver ultrasound.TCM differentiation types based on the co nsensus that Chinese and Western medicine diagnosis and treatment of NAFLD which enacted on the 2011.Apply ROC Curve method to evaluate FAI value accuracy in th e diagnosis of NAFL.Through the 16.0 statistical methods to calculate the correlation between FAI value of NAFL and TCM syndrome types,the levels of fatty liver ultraso und,and other objective indicators.Results:1.The distribution of FAI value between different TCM syndrome types of NAFL have obvious correlation(F=59.054,P<0.001),FAI value(326.00±14.82)is highest in Phleg m and blood stasis type,The second is phlegm stagnation type(299.34±15.56),damp-heat type(293.91±23.25),liver depression and spleen weak type(264.54±13.58),liver depression and qi stagnation type(256.62±13.79).The distribution of phlegm and blood stasis type and the other TCM syndrome types have obvious correlation(P<0.05);The distribution of phlegm stagnation type and liver depression and qi stagnation type,liver depression and spleen weak type,Phlegm and blood stasis type have obvious correlation(P<0.05);T he distribution of damp-heat type and liver depression and qi stagnation type,liver dep ression and spleen weak type,Phlegm and blood stasis type have obvious correlation(P <0.05);In addition, The distribution of ultrasonic distribution trends between five TCM syndrome types have obvious difference|(x2=43.065,P<0.001).liver depression and spleen weak type,liver depression and qi stagnation type more performance mild(respectively 88.5%,83.8%);phlegm stagnation type,damp-heat type more performance moderate(respe ctively50%,46.9%);Phlegm and blood stasis type more performance severe(54.5%).2.Adopt the Spearman correlation analysis,the FAI value of NAFL with the positive correlation between ultrasonic classification(r=0.718,P<0.001).The distribution the FAI value of NAFL and ultrasonic classification have obvious correlation(F=93.663,P<0.001),As the degree of fatty liver is aggravating,FAI value will increase.3.Adopt the Pearson correlation analysis,the FAI value of NAFL with the positive correlation between BMI(r=0.568,P<0.001),the FAI value of NAFL with the positive correlation between TG(r=0.287,P<0.001).4.Adopt ROC curve analysis,FibroTouch diagnosis of moderate fatty liver area un der the ROC curve is 0.895(95%CI,0.844to0.947),and diagnosis of severe fatty liver ar ea under the ROC curve is 0.956(95%CI,0.917to0.995).5. Logistic regression analysis,with moderately severe NAFL as the dependent vari able,BMI of relative risk (OR value) of 1.343 (95%CI:1.114to1.619,P=0.002),Triglyceri des(TG) of OR value is 2.245 (95%CI:1.345to3.746,P=0.002),Fasting plasma glucose (FPG) of OR value is 2.120 (95%CI:1.188to3.784,P=0.011).Conclusions:1.There are difference of FAI value between different TCM syndrome types of N AFL,evaluate FAI value helps TCM syndrome differentiation.2.The FAI value in fatty liver in hierarchical diagnosis accuracy is higher,it can b e used as a kind of new technology to evaluate the severity of nonalcoholic simple f atty liver,has a good development prospect. |
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