暴露于化学物质的工人中，非酒精性脂肪性肝炎（NASH）的临床和组织病理学特征，无论是否伴有相关代谢状况。

Clinical and histopathological features of NASH in workers exposed to chemicals with or without associated metabolic conditions.

作者信息

Cotrim Helma P, De Freitas Luiz A R, Freitas Carolina, Braga Luciana, Sousa Rodrigo, Carvalho Fernando, Paraná Raymundo, Santos-Jesus Rogerio, Andrade Zilton

机构信息

Faculdade de Medicina, Hospital Universitário Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, Brazil.

出版信息

Liver Int. 2004 Apr;24(2):131-5. doi: 10.1111/j.1478-3231.2004.0897.x.

DOI:10.1111/j.1478-3231.2004.0897.x

PMID:15078477

Abstract

BACKGROUND/AIMS: Non-alcoholic steatohepatitis (NASH) has been associated with exposure to chemicals among workers from an industrial complex in Brazil. We investigated the NASH profile of these individuals associated or not with metabolic conditions.

METHODS

Eighty-four patients with NASH were classified into three groups: G1, 31 patients exposed to chemicals (benzene, xylene, vinyl chloride and others); G2, 30 exposed patients who also presented with obesity, hyperlipidemia and diabetes; and G3, 23 non-exposed patients who presented with metabolic conditions.

RESULTS

G1 and G2 were similar in terms of gender (97% and 100% males) and age (37+/-5.4 and 39+/-6.5 years). In G3, 74% were males and the age was 48+/-3.4 years (P<0.05). In G2, obesity was present in 26.6%, hyperlipidemia in 66.6% and diabetes in 6.6%. In G3, obesity was observed in 43.4%, hyperlipidemia in 30.4% and diabetes in 26%. Macro- and microsteatosis were observed in 100% of cases. Perisinusoidal fibrosis was observed in 71% patients in G1, 80% in G2 and 52% in G3 (P<0.05). Histological evidence of cholestasis was present in 53% of cases in G1, 50% in G2 and 13% in G3 (P<0.05).

CONCLUSIONS

Exposure to chemicals appears to be an independent risk factor for NASH that presents a peculiar profile. It is more frequently seen in men younger than non-exposed ones. Steatosis, fibrosis and cholestasis were frequent histological findings. Co-existing metabolic factors did not seem to influence clinical or histopathological presentation.

摘要

背景/目的：在巴西一个工业园区的工人中，非酒精性脂肪性肝炎（NASH）与接触化学物质有关。我们调查了这些个体中与代谢状况相关或无关的NASH特征。

方法

84例NASH患者被分为三组：G1组，31例接触化学物质（苯、二甲苯、氯乙烯等）的患者；G2组，30例同时患有肥胖、高脂血症和糖尿病的接触化学物质的患者；G3组，23例患有代谢疾病的未接触化学物质的患者。

结果

G1组和G2组在性别（分别为97%和100%为男性）和年龄（分别为37±5.4岁和39±6.5岁）方面相似。G3组中，74%为男性，年龄为48±3.4岁（P<0.05）。G2组中，26.6%存在肥胖，66.6%存在高脂血症，6.6%存在糖尿病。G3组中，43.4%观察到肥胖，30.4%存在高脂血症，26%存在糖尿病。100%的病例观察到宏观和微观脂肪变性。G1组71%的患者观察到窦周纤维化，G2组为80%，G3组为52%（P<0.05）。G1组53%的病例存在胆汁淤积的组织学证据，G2组为50%，G3组为13%（P<0.05）。