祛湿化瘀方对单纯高脂饮食诱导的大鼠脂肪肝的防治作用

目的：观察中药祛湿化瘀方治疗非酒精性脂肪肝的疗效。方法：SD雄性大鼠36只，SPF级，随机取5只为正常组。其余大鼠以高脂饲料（普通饲料＋2％胆固醇＋10％猪油）饲养12周诱导脂肪肝。期间在第7周起，按随机号分模型组（11只）、祛湿化瘀方组（10只）及对照药物甘乐组（10只），分别予以相应药物或蒸馏水灌胃6周。取材后观察肝组织病理（HE染色和油红染色）、电镜超微结构；肝组织甘油三酯（TG）、游离脂肪酸（FFA）含量；血清ALT和AST活性、胰岛素抵抗指数、血脂等变化。结果：模型组肝体肥大，肝组织出现显著的脂肪变性，电镜可见肝细胞内存在大量脂滴，肝组织中TG含量达正常组5．2倍、FFA含量显著升高，但血脂含量和ALT、AST活性及胰岛素抵抗指数无显著变化。祛湿化瘀方组可显著改善肝组织病理变化，显著降低肝组织TG和FFA含量（其均值分别为模型组的54．5％和72．5％），并显著优于对照药物甘乐组。结论：祛湿化瘀方对单纯高脂饮食诱导的非酒精性脂肪肝有理想疗效，值得深入研究。     

The epidemiology of non-alcoholic steatohepatitis (NASH) in the United States between 2010-2020: a population-based study

Introduction and objectivesNon-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD) that can progress to liver cirrhosis, liver failure and hepatocellular carcinoma. It is the second leading cause of liver transplant in the US. We aim to investigate the prevalence, demographics and risk factors NASH patients in the US.Patients and methodsWe used a large database (Explorys IBM) that aggregates electronic health records from 26 nationwide healthcare systems. We identified adults with NASH between 2010-2020. Demographics including age, gender and race were collected. NASH risk factors including Diabetes Millets (DM), Hyperlipidemia (HLD), Hypertension (HTN) and Obesity were also collected. Cochran-Armitage test was used to assess the statistical significance of year-by-year trend. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) of risk factors.ResultsNASH annual prevalence rate increased from 1.51% in 2010 to 2.79% in 2020 (p < 0.0001). The proportion of patients with NASH by gender was 54.1% female vs 45.9% male (OR 1.04 [0.91-1.11]). Caucasian had higher odds of NASH than non-Caucasian (OR 1.42 [1.31-1.54]). NASH is strongly associated with DM and obesity (OR 18.61 [17.35-19.94]) and (OR 20.97 [17.87-23.21]), respectively. Other components of metabolic syndrome were associated with NASH to a lesser degree; HTN (OR 3.24 [3.20-3.28]) and HLD (OR 4.93 [4.85-4.01]).ConclusionThe prevalence of NASH has significantly increased in the US in the last decade. This is likely related to the increased prevalence of risk factors as well as increased awareness of the disease.     

电针疗法对肥胖型非酒精性单纯性脂肪肝患者体重指数的影响

目的：观察电针疗法对非酒精性单纯性脂肪肝（NAFL）患者体重指数的影响。方法：将60例肥胖型NAFL患者随机分为电针治疗组和普通针刺对照组,两组患者均在调整饮食、适量运动的基础上治疗3个月。结果：两组患者的体重、体重指数、腰围、臀围均较治疗前下降（P﹤0.01）,治疗组患者体重指数、腰臀比值与对照组比较差异有显著性意义（P﹤0.05）。结论：电针和普通针刺均可降低肥胖型NAFL患者的体重、体重指数、腰围、臀围,电针效果明显优于普通针刺。     

祛湿化瘀方对CCl4复合高脂低蛋白饮食诱导的大鼠脂肪肝的防治作用

目的探讨中药祛湿化瘀方防治非酒精性脂肪肝的疗效及作用机制。方法将Wistar雄性大鼠采用四氯化碳(CCl4)皮下注射及高脂低蛋白饮食诱导,复制大鼠脂肪肝模型在造模2周后,随机分模型组、祛湿化瘀方组及甘乐对照组。用药后,观察肝组织病理变化,肝组织甘油三酯(TG)、游离脂肪酸(FFA)含量和谷氨酰转肽酶(GGT)、超氧化物歧化酶(SOD)活性,血清肝功能和血脂指标及肿瘤坏死因子α(TNF-α)含量和肝组织TNF-α蛋白表达。结果模型组肝组织TG、FFA含量分别达正常组的5.3、1.9倍,肝组织出现严重的大泡样脂肪变性,肝脏炎症表现明显;祛湿化瘀方组的上述改变显著减轻,其肝组织TG、FFA含量显著低于模型组。同时可显著降低在模型组中异常升高的肝组织GGT活性及ALT、AST活性,显著提高模型组中低下的肝组织SOD活性,并且可显著降低血清TNF-α含量和肝组织中TNF-α蛋白的表达;对照组主要表现为有显著的抗肝损伤作用,其肝组织TG、FFA含量变化与模型组比较无显著性差异。结论祛湿化瘀方对CCl4高脂低蛋白饮食诱导的脂肪肝及其炎症有理想的防治作用。     

晚期自噬在非酒精性脂肪肝中的促凋亡作用

目的 在非酒精性脂肪肝体外模型中研究油酸长期刺激对自噬的影响及其作用.方法 用含浓度为400 μmol/L油酸的DMEM高糖培养基培养肝癌HepG2细胞,制作体外非酒精性脂肪肝细胞模型.向肝癌HepG2细胞转染GFP-LC3质粒,通过观察LC3Ⅱ绿色荧光斑点确定自噬的发生.采用PI3k抑制剂LY294002抑制自噬.用...     

非酒精性脂肪肝64例临床分析

目的：提高临床医师对非酒精性脂肪肝的早期诊断和防治水平。方法：分析我院2005年-2007年诊断的64例非酒精性脂肪肝的临床资料。结果：64例病人经综合治疗,病情均有不同程度好转,脂肪肝程度减轻,血脂、血糖下降。结论：非酒精性脂肪肝,在早期诊断及综合治疗的同时,积极治疗原发病,非酒精性脂肪肝是可以防治的。     

Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease

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