Histology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in Adults and Children.
Histology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in Adults and Children.
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DOI：
10.1016/j.cld.2015.10.011
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发表时间：
2016-05
影响因子：
5.1
通讯作者：
Makhlouf HR
中科院分区：
文献类型：
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作者：
Kleiner DE;Makhlouf HR
非酒精性脂肪性肝病(NAFLD)是一种与肥胖、糖尿病和代谢综合征相关的肝脏疾病。尽管脂肪变性是NAFLD的主要组织学特征，但NAFLD患者的肝活检可显示广泛的表现，包括门静脉和小叶炎症、气球和凋亡性肝细胞损伤、Mallory-Denk小体、巨线粒体和纤维化。非酒精性脂肪性肝炎(NASH)是NAFLD的一种进行性亚型，最初通过与酒精性肝炎的类比来定义。NASH的特点是肝细胞损伤呈气球状，常伴有Mallory-Denk小体和某种程度的纤维化。幼儿可能有一种进行性NAFLD的交替模式，其特征是脂肪变性、炎症和纤维化的1区分布。有几种分级和分期系统用于自然历史研究和临床试验，但都需要足够的活组织检查，以最大限度地减少由于采样不足造成的错误。有关短期自然病史的一些信息可以从配对的活检研究中获得。这些研究表明，虽然NASH通常表现为纤维化随着时间的推移而进展，但一些患者会表现出疾病的消退。
Nonalcoholic fatty liver disease (NAFLD) is the liver disease associated with obesity, diabetes and the metabolic syndrome. Although steatosis is a key histological feature, liver biopsies of patients with NAFLD can show a wide range of findings, including portal and lobular inflammation, ballooning and apoptotic hepatocellular injury, Mallory-Denk bodies, megamitochondria and fibrosis. Nonalcoholic steatohepatitis (NASH) is a progressive subtype of NAFLD first defined by analogy to alcoholic hepatitis. The characteristic finding in NASH is ballooning hepatocellular injury, often accompanied by Mallory-Denk bodies and some degree of fibrosis. Young children may have an alternate pattern of progressive NAFLD characterized by a zone 1 distribution of steatosis, inflammation and fibrosis. Several grading and staging systems exist for use in natural history studies and clinical trials, but all require adequate biopsies to minimize errors due to under sampling. Some information about the short term natural history is available from paired biopsy studies. These studies have demonstrated that while NASH generally shows fibrosis progression over time, some patients will show regression of disease.