NASH患者脂肪组织巨噬细胞计数的变化  

Macrophage counts in adipose tissues in patients with nonalcoholic steatohepatitis

作　　者：邵小娟[1] 张艳梅[1] 魏艳玲[1] 樊丽琳[1] 刘卉[1] 杨均[1] 邢寒阳[1] 崔红莉[1] 颜綦先[1] 唐雯[1] 孙文静[1] 陈东风[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所消化内科,重庆市400042

出　　处：《实用肝脏病杂志》2013年第6期502-504,共3页Journal of Practical Hepatology

基　　金：国家自然科学基金青年科学基金项目(81200297);国家自然科学基金项目(81170382)

摘　　要：目的研究非酒精性脂肪性肝炎(NASH)患者网膜脂肪及皮下脂肪巨噬细胞数量的变化。方法选择NASH伴单纯性胆囊结石患者22例和单纯性胆囊结石患者28例。在腹腔镜手术中取肝组织、网膜脂肪组织和皮下脂肪组织。常规检测BMI、腹围、血糖、血酯、HOMA指数、胰岛素、游离脂肪酸;采用免疫组化法检测脂肪组织巨噬细胞。以抗CD68抗体标记巨噬细胞,抗CD11C标记M1亚群巨噬细胞,抗CD206抗体标记M2亚群巨噬细胞。结果 NASH患者血清AST(31.43±14.76)U/L对(23.68±9.64)U/L、TG(2.42±0.82)mmol/L对(1.65±0.47)mmol/L、胰岛素(83.18±44.34)mlu/L对(51.15±32.12)mlu/L和HOMA指数(21.00±14.75)对(12.43±10.66)显著高于胆囊结石患者(P<0.05);NASH患者网膜脂肪组织巨噬细胞数量为(34.41±15.35),皮下脂肪组织巨噬细胞数量为(27.91±11.13),而胆囊结石患者分别为(29.93±11.49)和(15.57±5.67),(P<0.01);在22例NASH患者中,其NAS评分7分2例,6分6例,5分9例,4分5例。NASH患者皮下脂肪组织巨噬细胞、M1亚群巨噬细胞和M2亚群巨噬细胞数量与NAS评分呈正相关(P<0.01),但在网膜脂肪组织中三种细胞与NAS评分无显著性相关(P>0.05)。结论网膜脂肪及皮下脂肪中的巨噬细胞数量变化参与了NASH的发病过程。Objective To investigate the changes of macrophage counts in adipose tissues in patients with nonalcoholic steatohepatitis（NASH）. Method 22 patients with NASH and 28 with gallbladder stone were includ-ed in this study. The epiploic adipose tissues and subcutaneous adipose tissues during laparoscopic cholecystecto-my were obtained. We detected the clinical data as respect to age,gender,BMI,abdominal circumference,glucose, ALT,AST,total cholesterol （TG）,HOMA index,insulin and free fatty acids. The infiltration of macrophages （anti-CD68）,macrophage M1（anti-CD11C） and macrophage M2（anti-CD206）in epiploic and subcutaneous adipose tis-sues were assessed by immunohistochemical staining. Results The serum AST（31.43±14.76）U/L vs. （23.68± 9.64）u/L,TG（2.42±0.82）mmol/L vs.（1.65±0.47）mmol/L,insulin（83.18±44.34）mlu/Lvs. （51.15±32.12）mlu/L and HOMA-index（21.00±14.75） vs.（12.43±10.66）in patients with NASH were significantly higher than those in pa-tients with gallbladder stone（P〈0.05）;The counts of macrophages in epiploic and in subcutaneous adipose tissues （34.41±15.35）and（27.91±11.13）,respectively in patients with NASH were higher than those（29.93±11.49）and （15.57±5.67）,respectively,P〈0.01） in patients with gallbladder stone;The NAS scores were 7 in two,6 in six,5 in nine,and 4 in five cases out of the 22 patients with NASH;The counts of macrophages,M1 and M2 macrophages in subcutaneous adipose tissues in NASH patients were positively correlated to NAS scores（P〈0.01）, but not in epiploic adipose tissues（P＆gt;0.05）. Conclusion The infiltration of the macrophages and macrophage po-larization in epiploic and subcutaneous adipose tissues were associated with the development of NASH.

关 键 词：非酒精性脂肪性肝炎 巨噬细胞 M1亚群 M2亚群 

分 类 号：R575.1[医药卫生—消化系统]