The Application Of Fibrotouch For The Diagnosis Of Non-alcoholic Fatty Liver Disease And Effect Evaluation Of Qushi Huoxue Cream On Non-alcoholic Fatty Liver Disease

Objective:To investigate the transient elastography(FibroTouch)with liver stiffness measurement(LSM)and fat attenuation parameters(FAP)on nonalcoholic fatty liver disease(NAFLD),and to explore their correlation with alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(CHOL),triglyceride(TG),glutamyl transpeptidase(GGT),uric acid(UA),etc,furthermore,to evaluate the effects of Qushi Huoxue on NAFLD with FibroTouch.Methods:To find the NAFLD patients from Ruikang Hospital Affiliated to Guangxi College of traditional Chinese Medicine,in-hospital and out-hospital patients with NAFLD diagnosed by B-mode ultrasound of 240 cases.To collect these patients’name,sex,age,body mass index(BMI),liver function,renal function,blood lipid,fasting blood glucose,etc.There were 155 males and 85females,aged 47.5(18,79)years old.Using Fibrotouch to detect patients with Fatty attenuation parameters(FAP)and Liver stiffness measurement(LSM),FAP<240 dB/m were divided into Negative groups of FAP,more than 240 dB/m were divided into Positive group of FAP;LSM>7.3 kPa was defined the fibrosis,less than 7.3 kPa was defined non-fibrosis.We retrospectively analyzed the relationship between FAP/LSM and BMI,liver function,renal function,blood lipid,fasting blood glucose,and other related indicators.And we evaluated the FAP/LSM whether it was affected by biochemical indexes and to evaluate the effect of Qushi Huoxue on NAFLD.SPSS20.0 software package was used for statistics.Results:(1)According to different degree of FAP values and LSM values,ALT boxplot showed that FAP values and LSM values were affected by ALT level.The scatter diagram indicated that there was no connection between FAP and LSM.(2)Compared Negative groups of FAP and Positive group of FAP with LSM,BMI,ALT and HDL,all P values were less than 0.05,the differences were statistically significant;AST,GGT,UA,GGT,LSM and BMI were not statistically significant(P were all>0.05).Compared Fibrosis group and Non-fibrosis group with FAP,BMI,ALT,AST and GGT,the differences were statistically significant(P were all<0.05);PLT,UA,HDL,LDL,TG,CHOL and GLU were not statistically significant(P were all>0.05).(3)The research indexes were analyzed by Spearman correlation analysis.FAP value detected by Fibrotouch was positively correlated with LSM,BMI,ALT,AST,GGT and TG(r_s<0,P<0.05),but was negatively correlated with HDL(r_s<0,P>0.05);there were no statistical significance With UA,LDL,CHOL,GLU and PLT(P>0.05).The coefficient of correlation with BMI is the largest,and the r_s is 0.554.Fibrotouch detection of LSM was positively correlated with BMI,ALT,AST and GGT,but was negatively correlated with UA;there were no statistical significance With TG,HLD,LDL,CHOL,GLU and PLT.(4)Binary regression of Logistic to analysis the influence factors of LSM,the results showed that BMI was the independent factor of LSM.(5)ROC curve in evaluation of BMI for diagnosis of Hepatic fibrosis.Compared with area with 0.5,the area under the curve for 0.652 was a significant difference in statistics(P<0.05).It indicates that BMI has certain diagnosis value for liver fibrosis.The cut-off value of BMI was26.30kg/m~2,and the specificity and sensitivity were 60.2%and 66.4%respectively.(6)The collection of 13 cases of NAFLD patients treated by Qushi Huoxue Cream for 3 months,to compare the FAP and LSM with the biochemical indicators before and after treatment,FAP and TG were less than that before treatment,they were statistically significant differences(P were all<0.05).There were no change before and after treatment with LSM,ALT,AST,GGT and CHOL(P were all>0.05).(7)We measured the FAP with Fibrotouch of 13 cases after treatment for 3 month.Result showed that 4 markedly improved,6 effective,and 3 no effective,the overall effective rate was 76.92%.Conclusion:(1)Fibrotouch detection of FAP value was influenced by BMI and ALT、AST、GGT.(3)BMI can be applied to diagnosis of liver fibrosis,and the cut-off point of BMI was 26.30 kg/m2.(3)Traditional Chinese medicine Qushi Huoxue Cream,can significantly reduce serum levels of TG and FAP.we deduced that Qushi Huoxue Cream has clearly effect on NAFLD patients,it can be evaluated by FAP with Fibrotouch.