86例非酒精性脂肪肝的临床与病理分析  

Clinical and pathological analysis of 86 patients with nonalcoholic fatty liver

作　　者：郑瑞丹[1] 孟家榕[1] 陆伦根[2] 谢建清[1] 朱皓皞[1] 徐成润[1] 曾民德[2] 

机构地区：[1]福建省漳州市解放军第175医院肝病治疗中心,363000 [2]上海第二医科大学附属仁济医院消化科

出　　处：《实用肝脏病杂志》2007年第4期217-219,共3页Journal of Practical Hepatology

基　　金：上海市教委科技发展基金(No:Y0205);漳州市科技局基金资助(No:Z04094)

摘　　要：目的研究非酒精性脂肪肝的临床与病理特征。方法对86例非酒精性脂肪肝的临床及病理资料进行回顾性分析。结果在86例非酒精性脂肪肝患者中,肥胖性脂肪肝为42例(48.8%),糖尿病性脂肪肝为11例(12.8%),高脂血症性脂肪肝为27例(31.4%),慢性丙型肝炎伴脂肪肝为6例(70%);73.3%的患者有非特异性症状;高胆固醇血症者22例(25.6%),高甘油三酯血症者27例(31.4%);丙氨酸转氨酶升高4例,天冬氨酸转氨酶升高3例;肝活检前B超诊断脂肪肝63例(73.3%)、B超不支持脂肪肝23例(26.7%);病理检查,I级肝细胞脂肪变26例(30.2%),II级肝细胞脂肪变41例(47.7%),III级肝细胞脂肪变19例(22.1%)。结论非酒精性脂肪肝主要由肥胖、高脂血症和糖尿病引起,B超是诊断脂肪肝的主要方法,选择性的肝活检有助于进一步明确诊断。Objective To observe the clinical and pathological features of nonalcoholic fatty liver. Methods Clinical and pathological data of 86 patients with NAFLD were analyzed retrospectively. Results Of the 86 patients with NAFLD ,42 （48.8%） were with obesity, ll（12.8%）with diabetes mellitus, 27（31.4%）with hyperlipemia and 6（7.0%） with chronic hepatitis C ; 22 （25.6 %） patients were with hypercholesteremia and 27 （ 31.4 % ） with hypertriglyceridemia; 4 with elevated ALT and 3 with elevated AST;63（73.3%）were diagnosed by using B-mode ultrasound before liver biopsies and 23（26.7%） missed. Steatosis grade Ⅰaccounted for 30.2%, grade Ⅱ for 47.7% and grade Ⅲ for 22.1%. Conclusion The results suggests that obesity, hyperlipemia and diabetes mellitus play an important role in NAFLD. Abdominal sonography is the major method for diagnosis in nonalcoholic fatty liver. Liver biopsy is the essential methods to improve the diagnosis.

关 键 词：非酒精性脂肪肝 超声检查 肝活检 病理 

分 类 号：R575.5[医药卫生—消化系统]