Morita Yasuyo, Ueno Takato, Sasaki Nozomi, Kuhara Kouichiro, Yoshioka Shinichiro, Tateishi Yukio, Nagata Eisuke, Kage Masayoshi, Sata Michio
Nagata Hospital, Fukuoka, Japan.
Alcohol Clin Exp Res. 2005 Dec;29(12 Suppl):277S-81S. doi: 10.1097/01.alc.0000191777.36629.33.
This study compared the liver histology of patients with NASH and patients with ASH.
Subjects consisted of 79 patients (41 in the NASH group and 38 in the ASH group). We performed physical and laboratory examinations as well as liver biopsy in all subjects, and we evaluated the differences between the NASH and ASH groups. In addition, we compared the liver histology of patients with obesity, diabetes or hyperlipidemia within the NASH group.
BMI was significantly higher in the NASH group than in the ASH group. Steatosis and nuclear vacuoles were more prevalent in the NASH group than in the ASH group. On the other hand, ballooning hepatocytes, lipogranuloma, focal necrosis, acidophilic bodies and fibrosis were more remarkable in the ASH group than in the NASH group. The degrees of steatosis and lipogranuloma gradually decreased as the stage of liver fibrosis progressed. Necro-inflammation and fibrosis tended to be more remarkable in the ASH group than in the NASH group. In the NASH group, ballooning hepatocytes and acidophilic bodies were significantly higher in the group with diabetes than in that without diabetes. Perivenular fibrosis, pericellular fibrosis and portal fibrosis were also higher in the NASH group with diabetes than in the NASH group without diabetes. These findings suggested that diabetes is deeply involved in the development and progression of NASH.
本研究比较了非酒精性脂肪性肝炎（NASH）患者和酒精性脂肪性肝炎（ASH）患者的肝脏组织学情况。
研究对象包括79例患者（NASH组41例，ASH组38例）。我们对所有受试者进行了体格检查、实验室检查以及肝活检，并评估了NASH组和ASH组之间的差异。此外，我们还比较了NASH组内肥胖、糖尿病或高脂血症患者的肝脏组织学情况。
NASH组的体重指数（BMI）显著高于ASH组。NASH组的脂肪变性和核空泡比ASH组更常见。另一方面，ASH组的气球样变肝细胞、脂肪肉芽肿、局灶性坏死、嗜酸性小体和纤维化比NASH组更明显。随着肝纤维化程度的进展，脂肪变性和脂肪肉芽肿的程度逐渐降低。ASH组的坏死性炎症和纤维化往往比NASH组更明显。在NASH组中，糖尿病组的气球样变肝细胞和嗜酸性小体显著高于非糖尿病组。糖尿病NASH组的中央静脉周围纤维化、细胞周围纤维化和门脉纤维化也高于非糖尿病NASH组。这些发现表明，糖尿病与NASH的发生和发展密切相关。
