Abdelmalek M, Ludwig J, Lindor K D
Division of Gastroenterology and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
J Clin Gastroenterol. 1995 Mar;20(2):127-30. doi: 10.1097/00004836-199503000-00011.
Nonalcoholic steatohepatitis is a poorly understood disease that mimics alcoholic liver disease histologically. Its natural history is not well defined, although gradual progression to cirrhosis has been described. Most patients with this condition have been obese, with or without associated diabetes or hyperlipidemia. No known effective treatment exists for nonalcoholic steatohepatitis, although weight loss may have a beneficial effect. We report two cases of nonalcoholic steatohepatitis. One patient with well-established nonalcoholic steatohepatitis had cirrhosis with a complete loss of fat on subsequent liver biopsy despite a gain in weight, simulating cryptogenic cirrhosis. In another patient, the condition improved after use of ursodeoxycholic acid; this agent may be a potential therapeutic agent for the treatment of nonalcoholic steatohepatitis. We believe these two cases represent the spectrum of this condition: on the one end is a progressive liver disease that in some instances may be a cause of cryptogenic cirrhosis; at the other end, a potentially treatable liver condition.
非酒精性脂肪性肝炎是一种了解甚少的疾病，其组织学表现类似于酒精性肝病。尽管已有报道称其会逐渐发展为肝硬化，但其自然病程尚不明确。大多数患有这种疾病的患者都肥胖，伴有或不伴有糖尿病或高脂血症。目前尚无已知的有效治疗非酒精性脂肪性肝炎的方法，尽管体重减轻可能会有有益效果。我们报告两例非酒精性脂肪性肝炎病例。一例确诊为非酒精性脂肪性肝炎的患者出现肝硬化，尽管体重增加，但随后的肝脏活检显示脂肪完全消失，类似隐源性肝硬化。在另一例患者中，使用熊去氧胆酸后病情有所改善；这种药物可能是治疗非酒精性脂肪性肝炎的潜在治疗药物。我们认为这两例病例代表了这种疾病的范围：一端是一种进行性肝病，在某些情况下可能是隐源性肝硬化的病因；另一端是一种可能可治疗的肝脏疾病。
