Relationship between the change of ratio caudate lobe/right lobe of the liver and diameters in subjects with nonalcoholic fatty liver disease
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摘要:
目的探讨肝尾叶与肝右叶的各径线及比值的变化与非酒精性脂肪性肝病之间的关系。 方法选择在我院诊断为非酒精性脂肪性肝病变的病例147例及普通健康体检者227人为研究对象，分别测量其肝尾叶上下径、前后径、横径及肝右叶横径、最大斜径，计算肝尾叶横径与肝右叶的横径和肝尾叶上下径与肝右最大斜径比值，分析其与非酒精性脂肪性肝病之间的关系。 结果健康成人肝尾叶与不同程度的脂肪肝病人肝尾叶的上下径、前后径、横径及肝右叶横径、最大斜径均在统计学上显著性差异（P<0.05），在各径线中重度脂肪肝>中度脂肪肝>轻度脂肪肝>正常肝脏；轻、中、重度脂肪肝肝尾叶横径与肝右叶横径比值，以及肝尾叶上下径与肝右叶最大斜径比值均比较接近，无显著性差异。 结论肝尾状叶与右叶各径线变化与非酒精性脂肪性肝病轻重程度密切相关，肝尾叶与右叶径线的（P>0.05）比值变化与非酒精性脂肪肝病轻重程度关系不密切。 Abstract:Objective To explore the relationship between the change of ratio caudate lobe/right lobe of the liver and diameters in subjects with healthy livers and subjects with nonalcoholic fatty liver disease（NAFLD）. Methods the following ultrasonic measurements of caudate lobe and right lobe of the liver were performed in 374 adult subjects: 227 with healthy livers and 147 cases with NAFLD diagnosed in the Lecong Hospital: a: the upper and lower diameter, b: the anteroposterior diameter, c: the transverse diameter of caudate lobe of the liver and d: the transverse diameter, e: the maximum oblique diameter of right lobe of the liver were measured and compared the following ratios were calculated: c/d and a/e. Results Across all measurements there were significant differences (P<0.05) thus the sizes ranked from severely>moderately>mildly fatty liver>healthy liver. The ratio between c) (the transverse diameter of caudate lobe of the liver) and d) (the transverse diameter of right lobe of the liver and Ratio a) the upper and lower diameter of caudate lobe of the liver and e) (the maximum oblique diameter of the right lobe the liver) in different grades NAFLD were not significant differences.（P>0.05）. Conclusion the change of diameters of the caudate lobe and the right lobe of liver is closely correlated with different degrees of NAFLD,The changes in ratios of the caudate lobe and the right lobe of liver are not very closely correlated with different degrees of NAFLD,consequently the ratios are of limited value as diagnostic indicators. -
Key words:
- audate lobe of liver /
- rights lobe of liver /
- diameter /
- ratio /
- nonalcoholic fatty liver disease
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表 1 正常肝尾状叶与不同程度NAFLD肝尾状叶各径线超声测量结果比较（cm）
组别 例数 肝尾叶上下径(cm) 肝尾叶前后径(cm) 肝尾叶横径(cm) 测量值 95% 置信区间 测量值 95% 置信区间 测量值 95% 置信区间 下限 上限 下限 上限 下限 上限 正常肝脏 227 4.78±0.66 4.7 4.87 1.83±0.38 1.78 1.88 2.60±0.38 2.55 2.65 轻度脂肪肝 82 4.97±0.51 4.86 5.08 2.14±0.50 2.03 2.25 3.06±0.34 2.99 3.14 中度脂肪肝 50 5.35±0.74 5.14 5.56 2.35±0.47 2.22 2.48 3.26±0.40 3.15 3.37 重度脂肪肝 15 5.74±0.32 5.56 5.91 3.03±0.49 2.76 3.31 3.56±0.41 3.34 3.79 
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表 2 正常肝脏与不同程度NAFLD肝右叶横径及最大斜径超声测量结果比较（cm）
组别 例数 肝右叶横径(cm) 肝右叶斜径(cm) 测量值 95% 置信区间 测量值 95% 置信区间 下限 上限 下限 上限 正常肝脏组 227 9.09±0.76 8.99 9.19 11.81±1.00 11.68 11.94 轻度脂肪肝组 82 10.41±0.86 10.23 10.61 13.26±0.98 13.04 13.47 中度脂肪肝组 50 11.29±0.99 11.01 11.57 14.22±1.01 13.93 14.5 重度脂肪肝组 15 12.55±0.88 12.07 13.04 15.78±0.78 15.35 16.22
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表 3 肝尾叶横经(cm)与肝右叶横径(cm)比值统计表
组别 比值（均值） 均值的95% 置信区间 比值（中值） 中值的95% 置信区间 标准差 下限 上限 下限 上限 实际范围 正常肝脏组 0.288 0.282 0.294 0.291 0.284 0.297 0.954 0.047 轻度脂肪肝组 0.296 0.287 0.304 0.294 0.282 0.31 0.965 0.039 中度脂肪肝组 0.292 0.278 0.305 0.286 0.269 0.313 0.967 0.048 重度脂肪肝组 0.287 0.26 0.313 0.295 0.234 0.315 0.965 0.048 注：χ2=1.692,P=0.639,P>0.05
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表 4 肝尾叶上下径线(cm) 与肝右叶最大斜径(cm)比值统计表
组别 比值（均值） 均值的95% 置信区间 比值（中值） 中值的95% 置信区间 标准差 下限 上限 下限 上限 实际范围 正常肝脏组 0.408* 0.399 0.418 0.408 0.403 0.42 0.954 0.069 轻度脂肪肝组 0.377 0.366 0.388 0.372 0.357 0.378 0.965 0.049 中度脂肪肝组 0.377 0.362 0.392 0.38 0.362 0.394 0.967 0.053 重度脂肪肝组 0.364 0.352 0.375 0.361 0.347 0.378 0.965 0.021 *正常肝脏与脂肪肝轻、中及重组比较: χ2=19.76,P=0.00,P<0.01; 脂肪肝轻、中及重组比较χ2=0.388,P=0.824,P>0.05.
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