發(fā)布時(shí)間：2019-05-11 17:52

【摘要】：目的設(shè)計(jì)一個(gè)適合中國人群的、能夠快速篩檢非酒精性脂肪肝(NAFLD)的簡易篩檢工具,進(jìn)而為其有效管理及防治提供科學(xué)依據(jù)。方法采用橫斷面病例對(duì)照研究設(shè)計(jì)方法,以2013年1月1日—8月31日在西京醫(yī)院體檢中心接受健康體檢的15 000名成年人為研究對(duì)象。每名研究對(duì)象均接受肝臟超聲檢查、人體學(xué)測(cè)量、實(shí)驗(yàn)室檢查及問卷調(diào)查4種評(píng)估。采用SAS 9.2和SPSS 13.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,基于多因素Logistic回歸分析的結(jié)果,構(gòu)建NAFLD篩檢指數(shù)。結(jié)果 15 000名研究對(duì)象中有4 573人被排除,最終納入10 427人,經(jīng)超聲診斷,其中有2 215人被診斷為NAFLD,為病例組;其余8 212人為對(duì)照組。將10 427名研究對(duì)象隨機(jī)分成兩組,其中一組為訓(xùn)練樣本(n=5 213),另一組為驗(yàn)證樣本(n=5 214)。逐步多因素Logistic回歸分析顯示,體質(zhì)指數(shù)(BMI)、三酰甘油(TG)、空腹血糖(FPG)、天冬氨酸氨基轉(zhuǎn)移酶(AST)/丙氨酸氨基轉(zhuǎn)移酶(ALT)對(duì)NAFLD的影響有統(tǒng)計(jì)學(xué)意義(P0.05)。這些變量被用于構(gòu)建NAFLD篩檢指數(shù):NAFLD指數(shù)=2×BMI+TG+FPG-6×(AST/ALT)。該指數(shù)在訓(xùn)練樣本中的受試者工作特征(ROC)曲線下面積為0.843〔95%CI(0.831,0.855)〕,在驗(yàn)證樣本中的ROC曲線下面積為0.848〔95%CI(0.837,0.860)〕。結(jié)論 NAFLD指數(shù)是一個(gè)針對(duì)中國人群的簡單的、有效的NAFLD篩檢工具,其可為進(jìn)一步的評(píng)價(jià)和/或詳盡的生活方式治療篩選對(duì)象提供依據(jù),并有可能增加篩檢的成本效益值。
[Abstract]:Objective to design a simple screening tool suitable for Chinese population and can quickly screen (NAFLD) for nonalcoholic fatty liver, so as to provide scientific basis for its effective management and prevention and treatment. Methods A cross-section case-control study was conducted among 15,000 adults who underwent physical examination in the physical examination Center of Xijing Hospital from January 1 to August 31, 2013. Each subject was evaluated by liver ultrasound, anthropometric measurement, laboratory examination and questionnaire survey. SAS 9.2 and SPSS 13.0 statistical software were used for statistical analysis. Based on the results of multivariate Logistic regression analysis, the NAFLD screening index was constructed. Results of the 15 000 subjects, 4 573 were excluded and 10 427 were included in the study. Among them, 2 215 were diagnosed as NAFLD, and the other 8 212 as control group. Ten 427 subjects were randomly divided into two groups, one was training sample (n 鈮，

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