摘要：目的 探讨角蛋白片段CK-18(Cytokeratin-18)(M30)、胰岛素抵抗指数（HOMA-insulin resistance，HOMA-IR)在非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD)CT 分级诊断中的应用价值。方法 71例NAFLD按CT检测分组，轻度24例，中度22例，重度25例。71例NAFLD和66例正常对照组用ELISA测定CK-18(M30)，葡萄糖氧化酶法测定空腹血糖，化学发光法测定空腹胰岛素，采用稳态模型计算得出HOMA-IR。结果 CT分级轻、中、重度NAFLD组和正常对照组CK-18(M30)（ng/L）分别为138.55±40.48、209.87±58.62、261.72±71.39和97.63±23.28；HOMA-IR分别为2.18±0.94、3.54±1.19、4.60±1.57和1.63±0.81。结论 CK-18(M30)及HOMA-IR与NAFLD病情活动CT分级高度相关，CK-18(M30)及HOMA-IR可作为NAFLD疾病进展的评价指标。

Abstract: Objective To explore the clinical significance of keratin fragments CK-18 (M30), and insulin resistance index (HOMA-insulin resistance, HOMA-IR) detection in the non-alcoholic fatty liver disease（NAFLD） CT grading diagnosis. Methods 71 cases of non-alcoholic fatty liver disease detected by CT were divided into, mild group (24 cases), moderate group (22 cases) and severe group (25 cases). The CK-18 (M30), fasting blood glucose and insulin in NAFLD and 66 normal controls were measured by using ELISA, glucose oxidase, and chemiluminescence assay respectively. Results The concentrations of CK-18 (M30) in mild, moderate, severe NAFLD group and normal controls were 138.55 ± 40.48 ng/L, 209.87 ± 58.62 ng/L, 261.72 ± 71.39 ng/L, and 97.63 ± 23.28 ng/L respectively. The HOMA-IR in mild, moderate, severe NAFLD group and normal controls were 2.18 ± 0.94 ng/L, 3.54 ± 1.19 ng/L, 4.60 ± 1.57 ng/L, and 1.63 ± 0.81 ng/L respectively. The values of CK-18 (M30) and insulin resistance index were highly correlated with CT grading of non-alcoholic fatty liver disease activity. Conclusion The CK-18 (M30) and insulin resistance index could be used as index in evaluation of nonalcoholic liver disease progression.