Nonalcoholic Steatohepatits and Liver Steatosis Modify Partial Hepatectomy Recovery
Nonalcoholic Steatohepatits and Liver Steatosis Modify Partial Hepatectomy Recovery
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DOI：
10.3109/08941939.2014.971206
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发表时间：
2015-02-01
影响因子：
1.9
通讯作者：
Stockmann, Martin
中科院分区：
文献类型：
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作者：
Hoppe, Steffi;von Loeffelholz, Christian;Stockmann, Martin
背景：包括单纯性脂肪变性（NAFL）和脂肪性肝炎（NASH）在内的非酒精性脂肪性肝病（NAFLD）对部分肝切除术后肝脏恢复的影响尚未得到评估。这项初步研究调查了NAFLD是否对肝脏恢复有影响。方法：对31例选择行肝部分切除术的患者进行特征分析并纳入前瞻性研究。根据NAFLD活动评分对肝脏样本进行分期。术后第1、3、5、10天采用LiMAx法测定肝功能。结果：19例患者确诊为NAFLD （NAFL, n = 11； NASH, n = 8）。NAFL患者术前肝功能（p = 0.48）和POD 1、3、5时肝脏恢复与对照组相当（p分别为0.05），而POD 10时肝脏受损（p = 0.022）。NASH患者术前酶功能与对照组相当（p = 0.10），但POD 1 （p = 0.082）和5 （p = 0.062）水平有降低的趋势，POD 10 （p = 0.003）变得显著。结论：本研究提示NAFLD损害肝部分切除术后的功能恢复。
Background: The impact of nonalcoholic fatty liver disease (NAFLD) comprising simple steatosis (NAFL) and steatohepatitis (NASH) on liver recovery after partial hepatectomy has not been evaluated. This pilot study investigated whether there is an effect of proven NAFLD on liver recovery. Methods: Thirty-one patients elected for partial hepatectomy were characterized and included into a prospective study. Liver samples were staged according to the NAFLD activity score. Liver function was measured by using the LiMAx method on postoperative days (POD) 1, 3, 5, and 10. Results: Nineteen patients were identified to suffer from NAFLD (NAFL, n = 11; NASH, n = 8). In NAFL, preoperative liver function (p = .48) and hepatic recovery on POD 1, 3, and 5 was comparable to controls (p > .05, respectively), while it was impaired on POD 10 (p = .022). NASH patients had preoperative enzymatic function comparable to controls (p = .10), but there was a trend to reduced levels on POD 1 (p = .082) and 5 (p = .062), which became significant on POD 10 (p = .003). Conclusion: This study suggests that NAFLD impairs functional recovery assessed by LiMAx after partial hepatectomy.