The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies
The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies
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DOI：
10.1016/j.jhep.2004.09.012
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发表时间：
2005-01-01
影响因子：
25.7
通讯作者：
Angulo, P
中科院分区：
文献类型：
--
作者：
Adams, LA;Sanderson, S;Angulo, P
背景/目的：非酒精性脂肪性肝病（NAFLD）的组织学过程仍未明确。因此，我们检查了接受序贯肝活检的NAFLD患者的肝脏组织学。方法：回顾103例在没有有效治疗的情况下接受了连续肝活检的患者的数据，并以盲法对活检进行评分。结果：活检的平均间隔时间为3.2 +/- 3.0年（范围0.7-21.3）。37%的人纤维化阶段明显进展，34%的人保持稳定，29%的人纤维化阶段倒退。脂肪变性、炎症、肝细胞球囊化和马洛里氏玻璃样变的严重程度明显改善。在活检期间，转氨酶显著降低，脂肪变性和炎症特征得到改善，但纤维化阶段没有改善。纤维化变化率为-2.05 ~ 1.7个阶段/年。经多因素分析，糖尿病（P=0.007）和低初始纤维化期（P=0.007）
Background/Aims: The histological course of nonalcoholic fatty liver disease (NAFLD) remains undescribed. Therefore, we examined the liver histology of NAFLD patients who had undergone sequential liver biopsies.Methods: Data on 103 patients who underwent serial liver biopsies in the absence of effective treatment were reviewed, and biopsies scored in a blind fashion.Results: Mean interval between biopsies was 3.2 +/- 3.0 years (range 0.7-21.3). Fibrosis stage apparently progressed in 37%, remained stable in 34% and regressed in 29%. Severity of steatosis, inflammation, hepatocyte ballooning and Mallory's hyaline improved significantly. Aminotransferases decreased significantly between biopsies, paralleling improvement in steatosis and inflammatory features but not fibrosis stage. The rate of fibrosis change ranged from -2.05 to 1.7 stages/year. By multivariate analysis, diabetes (P=0.007) and low initial fibrosis stage (P