[The introduction into clinical practice of an algorithm for the diagnosis of liver steatosis in patients with viral pneumonia].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-08-28 DOI:10.26442/00403660.2025.08.203365

T A Turankova, A Y Brazhnikov, N G Moroz, A V Mudrova, D L Varganova, C S Pavlov

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引用次数: 0

Abstract

Aim: To study the ability and significance of detecting liver steatosis during chest computed tomography (CT) in patients with viral pneumonia.

Materials and methods: A prospective cohort study included 100 patients over the age of 18 who were hospitalized with an established diagnosis of viral pneumonia. To CT detection significant liver steatosis (more than 33%), several approaches were used: liver density less than 40 HU; decrease in liver density by at least 10 HU less than the spleen; the ratio of decrease in liver density to the spleen is less than 0.9.

Results: According to CT data 2 groups were identified: 25 patients with existing liver steatosis and metabolically associated fatty liver disease, and 74 patients of the control group without signs of significant steatosis, оne patient was excluded due to alcohol abuse. There was a significant difference in the study of liver density (31.68 ± 10.67 and 54.44 ± 5.95; p < 0.001), the ratio of decrease in liver density to spleen density (0.66 ± 0.22 and 1.16 ± 0.13; p < 0.001), as well as a decrease in liver density relative to the spleen (16.30 ± 10.38 and -7.26 ± 6.10; p < 0.001). In the steatosis group, a more severe course of pneumonia was noted (p = 0.041). The incidence of deterioration according to CT was comparable in both groups: 19 (76%) and 45 (60.8%); p = 0.169, although its severity was higher in the group with steatosis (p = 0.012). Patients from the steatosis group were significantly more often prescribed biological (88.0 and 39.19%; p < 0.001) and antibacterial therapy (68.0 and 40.54%; p = 0.017).

Conclusion: The use of assessment of liver steatosis according to CT data simultaneously with the study of the underlying disease can become an important diagnostic step determining the prognosis of the course of the disease, as well as a tool for risk stratification in patients with metabolically associated fatty liver disease.

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一种病毒性肺炎肝脂肪变性诊断算法的临床应用

目的：探讨病毒性肺炎患者胸部CT检查肝脏脂肪变性的能力及意义。材料和方法：一项前瞻性队列研究包括100名年龄在18岁以上的确诊为病毒性肺炎的住院患者。对于明显的肝脂肪变性（大于33%），采用以下几种方法：肝密度小于40 HU；肝脏密度比脾脏降低至少10 HU；肝脏密度与脾脏密度的比值小于0.9。结果：根据CT资料确定2组：存在肝脏脂肪变性及代谢性脂肪性肝病患者25例，对照组无明显脂肪变性体征74例，因酗酒排除1例。肝密度（31.68±10.67）和54.44±5.95,p < 0.001)、肝密度与脾密度的比值（0.66±0.22,1.16±0.13,p < 0.001）、肝密度与脾密度的比值（16.30±10.38,-7.26±6.10,p < 0.001）均有统计学差异。脂肪变性组出现了更严重的肺炎病程（p = 0.041）。CT显示两组的恶化发生率相当：19例（76%）和45例（60.8%）；P = 0.169，但脂肪变性组的严重程度更高（P = 0.012）。脂肪变性组患者接受生物治疗（88.0和39.19%,p < 0.001）和抗菌治疗（68.0和40.54%,p = 0.017）的频率显著高于对照组。结论：结合基础疾病的研究，利用CT资料评估肝脏脂肪变性，可成为判断病程预后的重要诊断步骤，也是代谢性脂肪肝患者危险分层的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.