Comparison of liver enzymes level and sonographic findings value with liver biopsy findings in nonalcoholic fatty liver disease patients.
Comparison of liver enzymes level and sonographic findings value with liver biopsy findings in nonalcoholic fatty liver disease patients.
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DOI：
10.4103/2277-9175.178785
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发表时间：
2016
影响因子：
1
通讯作者：
Abdolahi H
中科院分区：
文献类型：
--
作者：
Khodadoostan M;Shariatifar B;Motamedi N;Abdolahi H
本研究旨在探讨非酒精性脂肪性肝病（NAFLD）患者脂肪肝的超声诊断和肝酶水平与组织病理学异常和肝活检结果的关系。这项横断面研究在伊朗伊斯法罕AL Zahra医院胃肠病学诊所的109例确诊和治疗中的NAFLD患者中进行。记录所有患者的年龄、性别、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和碱性磷酸酶（ALP）水平。所有患者均行肝脏超声检查。通过肝活检评估脂肪变性分级和纤维化分期。我们招募了109名NAFLD受试者，他们有肝活检的指征，并符合我们研究的入选标准。其中，78例受试者（71.6%）为男性，31例受试者（28.4%）为女性。平均年龄为40.17 ± 11.01岁。我们的研究结果显示，有统计学显着的关系，超声检查结果和病理结果的基础上活检。肝酶（ALT、AST和ALP）水平与超声检查结果有显著相关性，而AST和ALT水平与组织学检查结果无显著相关性，而ALP水平与组织学检查结果（脂肪变性和纤维化）有显著相关性（P = 0.01）。超声检查结果可用于鉴别NAFLD患者的非酒精性脂肪性肝炎和纤维化分期，但AST和ALT水平不是鉴别这些患者纤维化和脂肪变性分期的可靠筛选试验。因此，肝活检仍然是确定NAFLD患者脂肪性肝炎和晚期纤维化的金标准。
This study aimed to examine the relationship between sonographic diagnosis of fatty liver and liver enzyme level with histopathologic abnormalities and liver biopsy findings in patient with the nonalcoholic fatty liver disease (NAFLD). This cross-sectional study conducted on 109 patients with diagnosed and under treatment NAFLD refer to Gastroenterology Clinics of AL Zahra Hospital in Isfahan, Iran. Age, sex, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) level recorded for all patients. Liver ultrasonography was performed for all patients. Steatosis grading and fibrosis stage were evaluated by liver biopsy. We enrolled 109 subjects with NAFLD who had an indication for liver biopsy and met inclusion criteria of our study. Of these, 78 subjects (71.6%) were male and 31 subjects (28.4) were female. Mean age was 40.17 ± 11.01 years old. Our results showed there was a statistically significant relationship between ultrasonographic findings and histologic findings based on biopsy. There was statistically significant relationship between liver enzyme (ALT, AST and ALP) level and ultrasonographic findings, but there was no significant relationship between AST and ALT level and histologic findings, but the relationship between ALP level and histologic findings (steatosis and fibrosis) was statistically significant (P = 0.01). Ultrasonographic finding may be can use to identify nonalcoholic steatohepatitis and stage of fibrosis in patients with NAFLD, but AST and ALT level is not reliable screening test to identify stage of fibrosis and steatosis in these patients. Therefore, liver biopsy remains the gold standard for establishing steatohepatitis and advanced fibrosis in patients with NAFLD.