EFFECT ON HEPATIC MORPHOLOGY OF TREATMENT OF OBESITY BY FASTING, REDUCING DIETS AND SMALL-BOWEL BYPASS
EFFECT ON HEPATIC MORPHOLOGY OF TREATMENT OF OBESITY BY FASTING, REDUCING DIETS AND SMALL-BOWEL BYPASS
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DOI：
10.1056/nejm197004092821502
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发表时间：
1970-01-01
影响因子：
158.5
通讯作者：
MURPHY, JF
中科院分区：
文献类型：
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作者：
DRENICK, EJ;SIMMONS, F;MURPHY, JF
对41名严重肥胖受试者在大规模减肥（超过100磅）期间进行了肝活检。受试者包括三组，他们接受了长期禁食、低热量饮食和肠道旁路手术治疗。前两组在急性体重减轻期间表现出肝细胞变性和局灶性坏死程度的一过性增加，伴随着脂肪浸润的进行性减少沿着。后期随访活检显示肝脏组织学正常。相比之下，旁路手术后，不同的，大量的脂肪变化，胆汁淤积，多核炎性浸润，弥漫性纤维化，胆管增生和致命的肝坏死。形态学变化发生时，肝功能检查仍在正常范围内。随访活检检查是判断旁路手术是否引起进行性脑实质损害的唯一可靠方法。
Liver biopsies in 41 grossly obese subjects were evaluated during massive weight reduction (more than 100 lb). The subjects comprised three groups who had been treated by prolonged fasting, low-calorie dieting and intestinal bypass surgery. The first two groups manifested a transient increase in the degree of hepatocellular degeneration and focal necrosis along with progressive diminution of fatty infiltration during acute weight loss. Late follow-up biopsies revealed histologically normal livers. In contrast, bypass surgery was followed, variously, by massive fatty changes, cholestasis, polynuclear inflammatory infiltrates, diffuse fibrosis, bile-duct proliferation and fatal hepatic necrosis. Morphologic changes occurred while liver-function tests were still within normal limits. Follow-up biopsy examinations are the only reliable means of judging whether a bypass procedure is causing progressive parenchymal damage.