山楂贝母汤治疗脂肪肝40例

[目的]观察山楂贝母汤对脂肪肝的临床疗效.[方法]选择脂肪肝患者74例,随机分为治疗组40例,对照组34例.治疗组口服山楂贝母汤,对照组服用多烯康胶丸,观察两组治疗后的总有效率、肝功能及血脂的变化.[结果]经治疗后治疗组总有效率85.0%,对照组58.8%,差异有统计学意义(P＜0.05);治疗组丙氨酸氨基转移酶、天冬氨酸转氨酶和谷氨酰转肽酶均明显降低,且优于对照组(P＜0.05,＜0.01);总胆固醇、三酰甘油(TG)及低密度脂蛋白胆固醇较治疗前显著降低,高密度脂蛋白胆固醇较治疗前明显升高,其中TG与对照组比较差异有统计学意义(P＜0.05).[结论]山楂贝母汤治疗脂肪肝疗效显著,能明显改善肝功能,降低血脂.     

脂炎消煎剂联合易善复治疗非酒精性脂肪性肝炎临床研究

目的:探讨脂炎消煎剂联合多烯磷脂酰胆碱胶囊(易善复胶囊)治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法:100例NASH患者随机分为治疗组50例和对照组50例,治疗组患者口服脂炎消煎剂和易善复胶囊,对照组患者服用易善复胶囊,观察两组患者治疗后的总有效率、肝功能及血脂的变化。结果:经治疗后治疗组总有效率优于对照组(P0.05);患者丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)和γ-谷氨酰转肽酶(GGT)均明显降低,且优于对照组(P0.05或0.01);同时总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)较治疗前显著降低(P0.05或0.01),高密度脂蛋白胆固醇(HDL-C)较治疗前明显升高(P0.05),其中TG与对照组比较差异有显著性意义(P0.05)。结论:脂炎消煎剂联合易善复胶囊治疗NASH疗效显著,能明显改善患者肝功能及降低血脂。     

二甲双胍片联合健脾调脂化瘀方治疗肥胖症并非酒精性脂肪性肝炎的临床疗效观察

[目的]观察二甲双胍片联合健脾调脂化瘀方治疗肥胖症并非酒精性脂肪性肝炎的临床疗效。[方法]临床收集肥胖症并非酒精性脂肪性肝炎患者109例,随机分为治疗组和对照组,治疗组55例,对照组54例。对照组给予二甲双胍片、多烯磷脂酰胆碱胶囊口服治疗,治疗组给予二甲双胍片联合中药健脾调脂化瘀方口服治疗,连续12周。观察2组患者治疗前后临床症状、体征、体质指数(BMI)及肝脏超声的变化,检测血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平的变化。[结果]治疗组总有效率为90.9%(40/55),对照组总有效率为75.9%(41/54),2组比较差异有统计学意义(P〈0.05)。与治疗前相比较,对照组患者血清ALT、AST、TG、TC水平降低(P〈0.05或P〈0.01),HDL-C水平升高(P〈0.05),LDL-C水平无明显变化(P>0.05);治疗组患者血清ALT、AST、TG、TC、LDL-C水平明显降低(P〈0.01),HDL-C水平明显升高(P〈0.01)。与对照组比较,治疗组患者血清ALT、AST、TG、TC、LDL-C水平降低,血清HDL-C水平升高,均优于对照组(P〈0.05)。[结论]二甲双胍片联合健脾调脂化瘀方治疗肥胖症并非酒精性脂肪性肝炎,具有良好的临床疗效。     

抗肝纤汤治疗丙型肝炎后肝硬化30例

[目的]观察自拟抗肝纤汤对丙型肝炎(丙肝)后肝硬化的疗效与机制。[方法]50例患者随机分为治疗组(30例)与对照组(20例),治疗组予自拟抗肝纤汤治疗,对照组予人参鳖甲煎丸治疗。检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、清蛋白/球蛋白(A/G)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层黏连蛋白(LN)。[结果]治疗组和对照组总有效率分别93.3%和60.0%(P<0.01);治疗组较对照组HA、PCⅢ、LN均下降(P<0.01);治疗组较对照组ALT、AST均下降,A/G有所上升(P<0.05,<0.01)。[结论]抗肝纤汤治疗丙肝后肝硬化有明显疗效。     

护肝宁片治疗非酒精性脂肪肝疗效观察

[目的]观察护肝宁片治疗非酒精性脂肪肝(NASH)的疗效.[方法]将165例NASH患者随机分为治疗组(110例)和对照组(55例),分别应用护肝宁片和硫普罗宁片治疗.观察两组患者治疗前及治疗6、12周时,肝功能及血脂指标的变化.[结果]两组患者治疗后的肝功能及血脂指标与治疗前比较均得到明显改善(P＜0.05);在治疗后6周及12周时,治疗组与对照组肝功能指标的比较差异无统计学意义(P＞0.05);治疗组治疗后12周时,三酰甘油(TG)降低,与对照组比较差异有统计学意义(P＜0.05).[结论]护肝宁片治疗NASH疗效明显,显著改善患者肝功能;且降低TG的疗效及安全性优于硫普罗宁片,值得临床上推广应用.     

地衣芽孢杆菌活菌胶囊治疗非酒精性脂肪性肝病的疗效评价

[目的]评价地衣芽孢杆菌活菌胶囊治疗非酒精性脂肪性肝病(NAFLD)的临床疗效。[方法]82例NAFLD患者被随机将患者分为治疗组(41例)与对照组(41例)。2组均避免不健康的饮食,保持健康的生活方式。对照组患者予甘草酸二铵肠溶胶囊治疗,治疗组患者在对照组基础上予以地衣芽孢杆菌活菌胶囊治疗,2组患者均连续治疗12周。治疗前及治疗12周后所有患者进行肝脏B超检查,比较2组患者临床症状改善情况,生化指标(ALT、AST,TG、TC)情况以及整体临床疗效。[结果]治疗组患者腹胀改善情况优于对照组(P0.05);治疗后2组患者肝功能指标(ALT、AST)血脂(TG、TC)指标均有下降,治疗组ALT、AST、TG、TC水平低于对照组(P0.05)。治疗组总有效率高于对照组(P0.05)。[结论]甘草酸二铵肠溶胶囊联合地衣芽孢杆菌活菌胶囊治疗NAFLD的临床疗效确切,可有效改善患者症状、血脂及肝功能,疗效优于单用甘草酸二铵肠溶胶囊。     

恩替卡韦联合水飞蓟宾胶囊治疗慢性乙型肝炎合并非酒精性脂肪性肝炎临床观察

目的:探讨恩替卡韦联合水飞蓟宾胶囊治疗慢性乙型肝炎(CHB)合并非酒精性脂肪性肝炎(NASH)的临床疗效。方法:选取我院收治的CHB合并NASH患者84例,随机分为治疗组与对照组,各42例。两组患者均采用恩替卡韦抗病毒治疗,治疗组患者另加用水飞蓟宾胶囊。比较两组患者治疗前及治疗24周、48周HBV DNA阴转率、ALT、AST、GGT、TC、TG、CRP及肝脏硬度值、脂肪肝指数(FLI)等指标变化。结果:治疗组患者HBV DNA阴转率48周时明显高于对照组,差异有统计学意义(P0.05);治疗后两组患者各项指标均比治疗前明显下降,且治疗组优于对照组,差异有统计学意义(P0.05);两组患者治疗后肝硬度值及FLI均比治疗前明显好转,且治疗组明显优于对照组,差异有统计学意义(P0.05)。结论:恩替卡韦联合水飞蓟宾胶囊治疗CHB合并NASH可明显降低HBV复制水平,改善患者肝脏微循环,减轻肝脏炎症,减轻或逆转NASH,临床疗效好,可推广应用。     

降脂益肝汤治疗非酒精性脂肪性肝炎临床观察

目的：观察降脂益肝汤治疗非酒精性脂肪性肝炎的临床疗效,探讨肝脾同调、化痰祛瘀疗法的作用。方法：将100例NASH患者随机分为治疗组50例和对照组50例。治疗组患者服用以肝脾同调、痰瘀并治法而选用的降脂益肝汤,1剂/d;对照组患者口服水飞蓟宾葡甲胺片,100mg/次,3次/d。两组疗程均为3个月。治疗前后分别检测两组患者血清丙氨酸氨基转移酶（ ALT）、总胆红素（ TBil）、总胆固醇（ TC）、甘油三酯（ TG）,并行肝脏B超检查。结果：治疗组和对照组总有效率分别为94.00％和74.00％,治疗组总有效率明显优于对照组（ P＜0.05）。治疗组患者治疗后ALT、 TBil、 TC、 TG较治疗前明显降低（P＜0.05）;对照组患者治疗后ALT、 TC、 TG较治疗前降低明显（P＜0.05）,而TBil治疗前后差异无统计学意义（P＞0.05）;两组间治疗后4项指标比较,治疗组降低更加明显,差异均有显著性意义（ P＜0.05）。结论：肝脾同调、痰瘀并治法治疗NASH可明显改善患者的肝功能、血脂水平,临床疗效肯定。     

水飞蓟素胶囊联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎的疗效观察

目的探讨水飞蓟素胶囊联合多烯磷脂酰胆碱对非酒精性脂肪性肝炎(NASH)的临床疗效。方法 80例NASH患者被随机分成2组,观察组采用当飞利肝宁胶囊联合易善复口服治疗,对照组仅采用易善复治疗,于治疗前及治疗8周后观察患者症状、肝功能、血脂、血糖及肝脏彩超变化。结果观察组症状改善情况优于对照组(P0.01或P0.05);两组丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆固醇降低,肝脏脂肪变性改善,但观察组改善更明显;两组患者总胆固醇水平降低,观察组明显优于对照组(P0.01)。结论当飞利肝宁胶囊联合易善复治疗非酒精性脂肪性肝炎具有较好的临床疗效,能够有效改善NASH患者的临床症状、肝功能、血脂、血糖及其肝脏影像学变化。     

疏肝降脂颗粒治疗非酒精性脂肪性肝炎临床观察

目的:观察疏肝降脂颗粒治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法:将200例明确诊断为NASH患者,随机分成两组,每组100例,治疗组患者口服疏肝降脂颗粒25g/次,3次/d,对照组患者口服当飞利肝宁胶囊1.0g/次,3次/d,两组患者疗程均为3个月。观察两组患者治疗前后血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(γ-GT);血脂总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL);肝脏与脾脏的CT值比值等变化和临床疗效。结果:与治疗前相比较,治疗组患者肝功能、血脂指标均有显著下降,且在改善肝功能、血脂方面均优于对照组,差异有显著性意义(P0.01)。肝/脾CT比值均有所升高,治疗组升高的较对照组明显,差异有统计学意义(P0.05)。治疗组总有效为92%,对照组总有效率为83%,两组比较差异有显著性意义(P=0.020.05)。结论:疏肝降脂颗粒治疗NASH有良好的效果。     

莪蚕健胃方治疗大鼠胃癌前病变作用机制的探讨

[目的]通过观察莪蚕健胃方对胃癌前病变大鼠胃黏膜组织细胞增殖、凋亡及Bcl-2蛋白表达的影响,探讨莪蚕健胃方治疗胃癌前病变的作用机制.[方法]采用N-甲基-N-硝基-N-亚硝基胍(MNNG)配合饥饱失常法诱导造模.设空白对照组,模型对照组,莪蚕健胃方大、中、小剂量组,进行常规病理检测,采用免疫组化SP法、TUNEL法检测胃黏膜组织细胞增殖核抗原(PCNA)、Bcl-2蛋白及凋亡指数(AI)的表达情况.[结果]莪蚕健胃方各剂量组胃黏膜组织病理学变化,中、重度异型增生率与模型对照组相比明显降低(均P＜0.05);莪蚕健胃方能明显下调胃癌前病变组织细胞的PCNA、Bcl-2的表达,上调AI.[结论]莪蚕健胃方对大鼠实验性胃黏膜癌前病变有逆转作用,抑制细胞增殖、诱导细胞凋亡可能是该方的作用机制之一.     

Improved nonalcoholic steatohepatitis after 48 weeks of treatment with the PPAR-gamma ligand rosiglitazone

Insulin resistance (IR) commonly is associated with nonalcoholic steatohepatitis (NASH). To establish whether IR causes NASH, this study was undertaken to determine if improving IR would improve the histologic features that define NASH. Thirty adults with prior biopsy evidence of NASH were enrolled to receive rosiglitazone, 4 mg twice daily for 48 weeks. All patients were overweight (body mass index [BMI] > 25 kg/m(2)) and 23% were severely obese (BMI > 35 kg/m(2)); 50% had impaired glucose tolerance or diabetes. Liver biopsy specimens were obtained before beginning treatment and at treatment completion. Twenty-six patients had posttreatment biopsies; of these, 22 had initial protocol liver biopsies that met published criteria for NASH on subsequent blinded evaluation. Within this initial NASH group, the mean global necroinflammatory score significantly improved with treatment and biopsies of 10 patients (45%) no longer met published criteria for NASH after treatment. Significant improvement in hepatocellular ballooning and zone 3 perisinusoidal fibrosis also occurred. Five patients withdrew early; the 25 patients completing 48 weeks of treatment had significantly improved insulin sensitivity and mean serum alanine aminotransferase (ALT) levels (104 initially, 42 U/L at the end of treatment). Adverse effects led to withdrawal of 3 patients (10%). Weight gain occurred in 67% of patients and the median weight increase was 7.3%. Within 6 months of completing treatment, liver enzyme levels had increased to near pretreatment levels. In conclusion, improving insulin sensitivity with rosiglitazone resulted in improved histologic markers of NASH, an observation suggesting that insulin resistance contributes to its development and that improving insulin sensitivity may be important in treating this liver disease.     

穴位敷贴联合中药治疗非酒精性脂肪性肝炎的临床研究

目的：观察穴位敷贴联合中药治疗肝郁脾虚型非酒精性脂肪性肝炎（NASH）的临床疗效和对患者生存质量的影响。方法：将72例肝郁脾虚型NASH患者随机分为两组。治疗组予穴位敷贴联合中药治疗12周;对照组予基础药物治疗12周。观察两组患者治疗前后症状体征、体重指数、生化指标、影像学指标和生存质量量表的变化。结果：治疗12周后,治疗组患者临床主要症状体征,包括胁肋胀痛、乏力、口苦等显著改善;体重指数明显下降,从26.04±2.03下降到23.62±2.05,与治疗前相比差异有显著性意义（P〈0.05）;血清生化指标ALT、γ-GT、TC、TG均较治疗前明显下降,差异具有显著性意义（P〈0.01或P〈0.05）;对照组患者ALT、TG较治疗前明显下降,差异具有显著性意义（P〈0.05）;组间比较,ALT、γ-GT、TC下降水平间的差异具有显著性意义（P〈0.05）,治疗组优于对照组。B超好转率治疗组为61.11%,对照组为38.89%,组间差异显著（P〈0.05）;生理职能、躯体疼痛、活力和精神健康方面有显著性改善,与对照组比较差异有显著性意义（P〈0.05）。结论：穴位敷贴联合中药治疗肝郁脾虚型NASH临床疗效好,可以提高患者生存质量,安全性好,是值得推广应用的治疗方案。     

Clinical features and outcomes of cirrhosis due to non-alcoholic steatohepatitis compared with cirrhosis caused by chronic hepatitis C

Background and Aim:  Ethnic differences in non-alcoholic steatohepatitis (NASH) are well-documented, but there has been no study on the prognosis of Japanese NASH patients with cirrhosis. Accordingly, we compared cirrhotic NASH with liver cirrhosis caused by chronic hepatitis C (LC-C) to clarify its clinical features and define the risk factors for death.
Methods:  A prospective evaluation of the outcomes of NASH patients with severe fibrosis was started in 1990. Data on age- and sex-matched patients with biopsy-proven LC-C were collected retrospectively and used as the control.
Results:  There were 68 patients with cirrhotic NASH and 69 with LC-C. The Child–Turcotte–Pugh (CTP) class was similar in these two groups. Although the outcome of the NASH group was better than that of the LC-C group, cirrhotic NASH followed a similar course to that of LC-C; that is, complications of cirrhosis developed, including hepatocellular carcinoma (HCC; the 5-year HCC rate was 11.3% for NASH and 30.5% for HCV) and death (the 5-year survival rates were 75.2% and 73.8%, respectively). HCC was the leading cause of death in both groups (NASH, 47%; HCV, 68%). The occurrence of HCC and the CTP class were significant risk factors for mortality in NASH patients according to a multivariate analysis (HCC: hazard ratio [HR] 7.96, 95% confidence interval [CI] 2.45–25.88, CTP class A: HR 0.17, 95% CI 0.06–0.50).
Conclusion:  In conclusion, the present study confirmed that cirrhotic NASH has a similar course to LC-C. The occurrence of HCC was the strongest predictor of mortality in the NASH groups. These findings may be helpful when deciding on therapeutic interventions for NASH and also for the daily management of these patients.     

理气化痰祛瘀法抗非酒精性脂肪性肝炎大鼠的脂质过氧化损伤

[目的]观察理气化痰祛瘀中药对非酒精性脂肪性肝炎（NASH）大鼠脂质过氧化反应的影响，探讨其防治NASH的作用机制。[方法]高脂饮食喂养12周诱导Wistar大鼠建立NASH模型，以不同剂量的理气化痰祛瘀中药预防及治疗，检测大鼠血清及肝组织丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSHPX）的水平，光镜观察肝组织切片病理学改变。[结果]模型大鼠肝组织出现了严重脂肪变和不同程度炎症细胞浸润。模型大鼠血及肝组织中MDA水平较正常大鼠显著升高，而SOD、GSH-PX活性则较正常大鼠显著降低。应用理气化痰祛瘀中药进行预防和治疗后，大鼠肝组织脂肪变程度和炎症活动程度较模型大鼠显著降低，同时血及肝组织MDA水平显著降低，而SOD、GSH-PX活性则显著提高。[结论]理气化痰祛瘀法中药对NASH有防治作用，其作用机制可能与抑制脂质过氧化反应有关。     

Factors associated with the presence of nonalcoholic steatohepatitis in patients with chronic hepatitis C

OBJECTIVES: The aim of this study was to identify factors associated with the presence of nonalcoholic steatohepatitis (NASH) in patients with chronic hepatitis C (CHC). METHODS: We studied 98 patients with CHC [47 with NASH (group HCV/NASH), 51 without NASH (group HCV)] and 85 with NASH not infected with hepatitis C virus (HCV) (group NASH). We determined factors associated with the presence of NASH in patients with hepatitis C. RESULTS: Group HCV/NASH patients resembled those with NASH. Body mass index (BMI) was higher in group HCV/NASH than in group HCV, but was similar to group NASH. Most HCV/NASH patients had risk factors for NASH. In patients infected with HCV, NASH and NASH-related lesions were independently associated with BMI, while steatosis score was associated with HCV genotype 3 and BMI. Fibrosis stage was independently associated with steatosis, necroinflammatory activity index, and NASH lesions. CONCLUSION: While HCV genotype 3 infection and BMI are associated with the presence of steatosis in CHC, BMI is the only factor independently associated with the presence of NASH in these patients. We suggest that overweight-related factors might induce NASH in CHC patients.     

Impact of glucose tolerance on the severity of non‐alcoholic steatohepatitis

Aims/Introduction: We investigated the relationship between non‐alcoholic steatohepatitis (NASH) and different stages of fasting plasma glucose (FPG) concentrations, and the association between factors related to glucose tolerance and severity of NASH. Materials and Methods: A total of 147 patients with non‐alcoholic fatty liver disease (NAFLD) who had undergone a liver biopsy were divided into three groups: a normal glucose tolerance (NGT) group, an impaired fasting glucose (IFG) group and a diabetes (DM) group. In addition, to investigate progression factors of NASH in the DM group, we divided the diabetic patients into two groups: a group with NASH (NASH group) and a group without NASH, the simple steatosis (SS) group. The relationship between the patients’ clinical parameters and the severity of NAFLD/NASH were analyzed. Results: In the patients with liver biopsies, the IFG group had the highest percentage of NASH. There was no correlation between FPG and either total NAFLD activity scores (NAS) or staging of NASH, but the fasting serum insulin was correlated significantly with both, even after adjusting for age, sex and body mass index. Among the diabetic patients, the fasting insulin values in the NASH group were significantly higher than in the SS group, but there were no differences in FPG or A1c values between the two groups. The fasting serum insulin correlated significantly with total NAS, but the FPG and A1c values did not. Conclusions: A high percentage of the IFG group developed NASH. Hyperinsulinemia, but not hyperglycemia, was associated with severity of NASH. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00134.x, 2011)     

Serum leptin levels in patients with nonalcoholic steatohepatitis

OBJECTIVE: Leptin is a peptide hormone that mainly regulates food intake and energy expenditure of human body. A close correlation between serum leptin levels and the percentage of body fat stores is well known. Nonalcoholic steatohepatitis (NASH) is a common disorder which causes serum liver enzyme elevation. In this study, the serum leptin levels were investigated in patients with NASH to determine a possible role in the pathogenesis and in patients with chronic viral hepatitis to ascertain the effect of hepatic inflammation on serum leptin level. METHODS: Forty-nine patients (38 men, 11 women) with NASH diagnosed by biopsy, 32 patients with biopsy-proven chronic viral hepatitis (21 men and 11 women), and 30 healthy adults (17 men, 13 women) enrolled in the study. Fasting blood samples were obtained, and serum leptin levels were measured by ELISA. Body mass index (BMI) was calculated for all subjects, and serum insulin, C-peptide, and lipoprotein levels were also detected. RESULTS: The mean serum leptin levels (+/-SEM) were 6.62 +/- 0.71, 4.24 +/- 1.0, and 4.02 +/- 0.46 ng/ml in NASH, chronic hepatitis, and the control group, respectively. Mean serum leptin level in the NASH group was significantly higher than those in the other groups tested. BMI was also slightly higher in the NASH group when compared to the other groups (26.7 +/- 0.3, 23.7 +/- 0.6, and 24.6 +/- 0.3, respectively). There was a significant correlation between BMI and serum leptin levels when all the subjects were evaluated together (NASH, hepatitis, and control groups, r = 0.337, p = 0.012) but not in the NASH group when evaluated alone (r = 0.238, p = 0.1). Of the predisposing factors for NASH, obesity was observed in 24% of patients and hyperlipidemia in 67%. Serum cholesterol and triglyceride levels were significantly higher in the NASH group than those in controls (p < 0.05). It has been detected that most of these patients consumed high amounts of fat in their dietary habits. CONCLUSIONS: The serum leptin levels were significantly higher in patients with NASH, while they were not affected by chronic hepatitis. This elevation is out of proportion to BMI of these patients and may be related to hyperlipidemia in most. Elevated serum leptin levels, therefore, may promote hepatic steatosis and steatohepatitis.     

Phase 3 drug pipelines in the treatment of non‐alcoholic steatohepatitis

Non‐alcoholic steatohepatitis (NASH), which is a more severe form of non‐alcoholic fatty liver disease, can at least partly lead to cirrhosis, hepatocellular carcinoma, and hepatic failure. Liver transplantation is the only option for NASH cirrhosis at this time. By 2020, NASH is projected to overtake hepatitis C as the leading cause of liver transplants in the USA. There are still no approved drugs for treating NASH. Although there are approximately 196 agents of investigational NASH therapies in various stages of development, we here mainly review phase 3 drug candidates in the pipeline for NASH. The NASH space across the seven major markets of the USA, France, Germany, Italy, Spain, the UK, and Japan, is set to rise from $618 million in 2016 to approximately $25.3 billion by 2026. However, the fact that the race to develop an effective drug against NASH has reached the home stretch, with five drug candidates (obeticholic acid, elafibranor, selonsertib, cenicriviroc, and resmetirom) in phase 3 stage of the trial, is welcome news for patients. The very earliest a NASH drug could hit the market is 2021, assuming all goes well as planned.     

NASH患者外周血单个核细胞TXNIP/NLRP3水平变化及其临床意义探讨

目的 探讨非酒精性脂肪性肝炎(NASH)患者外周血单个核细胞(PBMCs)硫氧还蛋白互作蛋白(TXNIP)/NOD样受体家族含pyrin结构域蛋白3(NLRP3)水平变化及其临床意义。方法 2019年1月～2021年1月我院收治的150例NASH患者和同期体检的单纯性脂肪肝患者45例,取外周血分离PBMCs,并检测TXNIP/NLRP3 mRNA。对NASH患者行两次肝穿刺活检,将肝组织病变程度分为轻度、中度和重度及进展和无进展组。结果 NASH患者血清ALT和AST水平分别为(72.2±6.9)U/L和(61.8±5.1)U/L,显著高于单纯性脂肪肝组【分别为(33.4±4.0)U/L和(31.3±3.1)U/L,P<0.05】;NASH组PBMCs TXNIP mRNA、NLRP3 mRNA和TXNIP/NLRP3比值分别为(1.9±0.1)、(1.5±0.1)和(1.3±0.1),显著高于单纯性脂肪肝组【分别为(0.7±0.1)、(0.6±0.1)和(1.1±0.1),P<0.05】;33例重度NASH组PBMCs TXNIP mRNA、NLRP3 mRNA和TXNI...