甲氰咪呱不同作用方式对非酒精性脂肪性肝炎大鼠作用的对比研究

目的探讨不同作用方式的甲氰咪呱对非酒精性脂肪性肝炎（NASH）大鼠的作用。方法雄性SD大鼠40只,随机分为4组,即：对照组、模型组、甲氰咪呱治疗组、甲氰咪呱预防组。对照组普通饲料喂养,模型组喂高脂饮食,甲氰咪呱治疗组在高脂饮食12周后给予甲氰咪呱200 mg.kg-1.d-1）灌胃治疗,甲氰咪呱预防组给予高脂饮食同时进行甲氰咪呱200 mg.kg-1.d-1灌胃。16周末处死各组大鼠,测定血清转氨酶（ALT、AST）及血脂（TG、TC）、血清TNF-α;光镜下观察肝脏组织病理形态学改变,测定肝组织丙二醛（MDA）含量和超氧化物歧化酶（SOD）活性。结果与对照组比较,模型组ALT、AST、TG、TC显著增高（P〈0.05）,甲氰咪呱治疗组及预防组较模型组降低（P〈0.05）,且预防组AST与治疗组比较有显著差异（P〈0.05）;与对照组比较,模型组MDA及血清TNF-α显著增高,SOD活性下降（P〈0.05）;甲氰咪呱治疗组及预防组与模型组比较,MDA显著降低,SOD活性升高,均有显著差异（P〈0.05）;与对照组比较,模型组肝脏脂肪变性程度和炎症活动度均显著增高（P〈0.05）;与模型组比较,甲氰咪呱治疗或预防给药均可促进上述指标恢复（P〈0.05）。结论甲氰咪呱对高脂饮食诱导的大鼠NASH有一定治疗效果,其有效阻遏了自由基引发的氧化应激,保持了氧化/抗氧化平衡,改善NASH大鼠脂肪变性,减轻炎症反应,且甲氰咪呱预防组的效果优于治疗组,说明对NASH的早期治疗更有益于NASH的转归。     

甲氰咪胍影响非酒精性脂肪性肝炎大鼠血糖、胰岛素等指标的实验研究

探讨非酒精性脂肪性肝炎（NASH）大鼠经甲氰咪胍治疗后肝微粒体CYP450、CYP2E1含量、血糖、胰岛素等指标的变化.将30只雄性SD大鼠随机分为对照组（n=10）、模型组（n=10）和治疗组（n=10）,治疗组给予甲氰咪胍200 mg·kg^-1·d^-1灌胃,饲养12周,分别于实验第4、6、8、10、12周采用剪尾取血法取血,前四次取血测定血糖、AST、ALT含量,最后一次处死大鼠后取血测定血糖、胰岛素、肝功、血脂、CYP450及CYP2E1含量,观察肝组织学特点.观察到模型组大鼠肝功、血糖指标升高,并随实验进展更加明显;治疗组CYP450、CYP2E1、ALT、AST含量均低于模型组（P＜0.05）,且大鼠的肝细胞损害明显减轻,但其余指标无显著差异.可见甲氰咪胍能够减轻NASH大鼠肝细胞损害,抑制CYP450、CYP2E1表达,改善肝功水平,不能改善胰岛素抵抗,及降低血糖、血脂.     

西咪替丁治疗大鼠非乙醇性脂肪性肝炎

目的:探讨西咪替丁对大鼠非乙醇性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)的治疗作用及其可能的作用机制．方法:将30只♂SD大鼠随机分为对照组(n= 10)、模型组(n=10)和治疗组(n=10),模型组和治疗组给予高脂饮食喂养,治疗组给予西咪替T200 mg／(kg·d)灌胃,12 wk后处死大鼠取血测定ALT、AST、血糖、胰岛素和透明质酸含量,观察肝脏组织学变化并测定肝组织CYP450及CYP2E1含量．光镜下观察肝组织病理学变化,进行肝组织炎症活动计分．结果:与对照组比较,模型组大鼠ALT、AST、血糖、胰岛素和透明质酸水平以及CYP450和CYP2E1含量升高,而治疗组ALT (t=5．16,P<0．05),AST(t=5．45,P<0．05), CYP450(t=3．91,P<0．05),CYP2E1(t=1．95, P<0．05),肝湿质量(t=9．24,P<0．05)及透明质酸(T=55,P<0．05)均显著低于模型组,治疗组肝组织炎症活动度计分显著低于模型组(6．40±5．85 vs 7．80±4．60,t=2．59,P<0．05),血糖、胰岛素与模型组比较无显著差异(P>0．05)．结论:西咪替丁能显著减轻NASH大鼠肝脏功能及形态损伤,可能是通过抑制肝细胞微粒体CYP450和CYP2E1的表达发挥作用．     

低铁负荷对大鼠非酒精性脂肪性肝炎的影响

目的研究非酒精性脂肪性肝炎（NASH）大鼠肝铁负荷的变化及低铁负荷对大鼠NASH的影响。方法SD雄性大鼠随机分为4组：正常对照组1、低铁对照组2、模型组3、低铁模型组4。实验的12周末观察血清胆固醇（TG）、甘油三酯（TC）、转氨酶（ALTAST）、血清铁（SI）、过氧化物歧化酶（SOD）、丙二醛（MDA）的含量以及肝匀浆铁、TG、TC、SOD、MDA的含量,观察肝组织病理学改变的特点。结果与正常对照组相比,模型组血清TG、TC、ALT、AST、MDA的含量明显升高,SOD的含量明显降低,血清铁含量升高不明显;肝匀浆TG、TC、ALT、AST、MDA及铁的含量明显升高,肝匀浆SOD的含量明显降低。与模型组相比,低铁模型组血清TG、TC、ALT、AST、SI、MDA含量明显降低,SOD的含量明显升高;肝匀浆TG、TC、SI、MDA含量明显降低,SOD含量明显升高。肝脏病理学切片示：模型组大鼠肝小叶内脂滴比率大于三分之一,造模成功,低铁模型组大鼠肝脏的炎症活动度计分及铁染色计分明显低于模型组。结论NASH大鼠肝脏铁负荷增加,低铁负荷可以减轻大鼠NASH的损伤程度。     

杞蓟制剂对非酒精性脂肪性肝炎大鼠肝组织TNF-α蛋白表达的影响

目的：观察杞蓟制剂对大鼠非酒精性脂肪性肝炎（nonalcoholic steatohepatitis，NASH）肝组织肿瘤坏死因子-α（Tumor necrosis factor，TNF-α）蛋白表达的影响，探讨其作用机制。方法：采用高脂饮食复制大鼠NASH模型。实验分正常对照组、模型组、杞蓟制剂组、复方蛋氨酸胆碱片对照组。观察动物一般情况。计算肝指数、肝组织细胞脂肪变性、炎症活动程度，测定血清丙氨酸转氨醇（ALT）、天门冬氨酸转氨酶（AST）、甘油三酯（TG）、总胆固醇（TCH）等指标。结果：与模型组相比，杞蓟制剂预防给药明显改善NASH大鼠肝指数、肝组织脂肪变程度、炎症活动程度及血清ALT、AST、TG、TCH等指标（P〈0．01或P〈0．05），同时明显降低肝组织TNF-α蛋白表达（P〈0．05），优于复方蛋氨酸胆碱片对照组（P〈0．05）。结论：杞蓟制剂抑制TNF-α蛋白在肝组织表迭是其防治NASH的重要机制。     

甲氰咪胍在非酒精性脂肪性肝炎进展过程中对肝纤维化的影响

目的研究甲氰咪胍对金属蛋白酶组织抑制因子（TIMP）、基质金属蛋白酶（MMP）等纤维化相关指标的作用，探讨甲氰咪胍对NASH大鼠肝纤维化进展的影响。方法26只雄性SD大鼠随机分为正常饮食对照组（n=6）、高脂饮食模型组（n=10）和甲氰咪胍治疗组（n=10），实验时间12周。生化法检测血清AST、ALT、ALP、TBIL、肝组织1℃，放免法检测HA，RT-PCR法检测TIMP-1、TIMP-2、MMP2、MMP13 mRNA的表达。病理切片检查和Ⅰ型胶原免疫组化染色观察组织学改变。结果与模型组比较，治疗组大鼠肝功改善，HA水平下降，TIMP-1、TIMP-2、MMP2表达降低，但仍高于对照组，与模型组无显著差异，MMP13表达无降低。治疗组肝组织脂肪变改善，炎症减轻，Ⅰ型胶原沉积减少。结论甲氰咪胍具有一定抗纤维化的作用。     

网络抗氧化剂对非酒精性脂肪性肝炎大鼠氧化应激作用的影响

目的探讨网络抗氧化剂对非酒精性脂肪性肝炎（NASH）大鼠氧化应激作用的影响。方法雄性SD大鼠30只,随机分为3组,正常对照组、模型组、网络抗氧化剂组。正常对照组普通饲料喂养,模型组喂高脂饮食,网络抗氧化剂组在高脂饮食12周后给予维生素E（100mg／kg）、维生素C（100mg／kg）、硫辛酸（40mg／kg）、辅酶Q10（100mg／kg）、还原性谷胱甘肽（100mg／kg）混合灌胃治疗。16周末处死各组大鼠,测定血清转氨酶（ALT、AST）及硒-谷胱甘肽过氧化物酶（Se-GSH-PX）活性,光镜下观察肝脏组织病理形态学改变,测定肝组织丙二醛（MDA）含量及超氧化物歧化酶（SOD）活性。结果与正常对照组比较,模型组大鼠血清ALT、AST显著升高（P〈0．05）;肝组织MDA含量增高（P〈0．05）,SOD及Se-GSH-PX活性下降（P〈0．05）;肝脏脂肪变性程度和炎症活动度均有显著增高（P〈0．05）,与模型组比较,网络抗氧化剂组可促进上述指标恢复（P〈0．05）。结论网络抗氧化剂对高脂饮食诱导的大鼠NASH有一定治疗效果,网络抗氧化剂之间协同增强的抗氧化能力有效阻遏了自由基引发的氧化应激,保持了氧化／抗氧化平衡,改善NASH大鼠脂肪变性,减轻炎症反应。     

脂肪肝

非酒精性脂肪性肝炎模型的建立——王建青等（安徽合肥安徽医科大学药学院230032）：《安徽医科大学学报》，2006，41（1）：61搦旧的：建立大鼠非酒精性脂肪性肝炎（NASH）模型。方法：将6SD大鼠，随机分为正常组（n=15）和模型组（n--15）。两组动物均给以普通饲料，模型组每天ig高脂、高糖、高蛋白乳剂，剂量递增。实验持续6周后，检测血清ALT、AST、TC、TG、HDL-C、LDL-C及用：脏TC、TG并行病理组织学检查。结果：模型组大鼠血清ALT、AST、T℃、HDL．C、LDL-C及肝脏TC、TG均显增高；病理组织学检查提示模型组大鼠肝细胞呈现弥漫性脂肪变性伴肝小叶炎症坏死。结论：利用改良乳剂灌胃的方法，成功复制出大鼠NASH模型。】     

非酒精性脂肪性肝炎发病机制的实验研究

目的：通过建立大鼠非酒精性脂肪性肝炎（NASH）动物模型,探讨NASH的发病机制。方法：通过持续12周的高脂肪、高胆固醇饮食建立大鼠NASH模型,造模结束时检测模型组及正常组血清转氨酶、游离脂肪酸（FFA）;测定肝匀浆丙二醛（MDA）、超氧化物歧化酶（SOD）、FFA;用免疫组化法标记肝组织细胞色素P450ⅡE1（CYPⅡE1）及溶菌酶（LYZ）免疫阳性细胞－Kupffer细胞。结果：造模大鼠存在血清和肝匀浆FFA升高,肝匀浆脂质过氧化终产物MDA增加,而抗氧化物质SOD减少,肝组织免疫组化示CYPⅡE1呈高表达,Kupffer细胞明显增多。相关分析表明：随着FFA的增加,CYPⅡE1表达增高,脂质过氧化损伤亦增强,并且肝脏炎症、坏死加剧。结论：FFA在NASH的发病机制中起着重要作用;FFA的增加及其所引起的一系列CYPⅡE1高表达、Kupffer细胞激活以及脂质过氧化损伤,共同导致NASH以及肝细胞坏死。     

姜黄素对非酒精性脂肪性肝炎大鼠肝组织TNF-α表达的影响

目的研究姜黄素防治非酒精性脂肪性肝炎（NASH）的作用及其机制。方法采用高脂饮食制备大鼠NASH模型。大鼠分正常对照组、模型组、姜黄素防治组、东宝肝泰防治组，观察肝细胞脂肪变性、炎症活动程度；采用免疫组化和Western blot技术检测各组大鼠肿瘤坏死因子α（TNF-α）蛋白表达变化。结果与模型组相比，姜黄素防治组大鼠肝细胞脂肪变性、炎症活动程度皆有明显改善（P〈20．05），TNF-α蛋白含量显著减少（P〈0．01），部分作用明显优于东宝肝泰防治组（P〈0．01或P〈0．05）。结论姜黄素有防治NASH作用，作用机制考虑与纠正致炎因子TNF-α蛋白高表达相关。     

舒肝活血化痰方对非酒精性脂肪性肝炎大鼠脂质过氧化的影响

[目的]探讨舒肝活血化痰方抗非酒精性脂肪性肝炎（NASH）大鼠脂质过氧化的作用机制。[方法]采用高脂饮食复制NASH大鼠模型，用舒肝活血化痰方治疗，以东宝肝泰为对照，观察其对模型大鼠肝功能、血脂、肝组织超氧化物歧化酶（SOD）活性、丙二醛（MDA）、羟脯氨酸（Hyp）水平及细胞色素P4502E1（CYP2E1）活性的影响。[结果]舒肝活血化痰方显著改善肝功能，降低血清总胆固醇、三酰甘油及低密度脂蛋白胆固醇的同时升高高密度脂蛋白胆固醇水平，并显著降低肝组织Hyp，抑制肝组织CYP2E1的活性。[结论]舒肝活血化痰方可有效干预大鼠NASH，抑制肝组织CYP2E1的表达及与其密切相关的脂质过氧化是该方干预作用的主要机制之一。     

细胞色素P450 2E1在大鼠急性肝损伤中的表达及其意义

目的研究细胞色素P4502E1在大鼠急性肝损伤中的表达变化及其意义。方法随机将Wista大鼠分成正常对照组和急性肝损伤组，采用四氯化碳制备急性肝损伤模型，并按染毒时间分为3、6、12、24、36和48h6个亚组，每组5只大鼠。采用western blot方法测定染毒后不同时间点肝组织细胞色素P4502E1蛋白的表达变化；测定大鼠血清ALT、AST水平和肝组织MDA浓度、SOD活性的变化以及采用电子自旋共振（ESR）技术测定大鼠肝组织自由基（ROS）浓度变化，HE染色观察肝组织病理形态学改变；结果四氯化碳可明显导致大鼠肝脏损伤，表现为：血清ALT、AST水平显著升高，肝组织MDA浓度和ROS含量显著增加。SOD活性明显下降，和正常对照组相比，差异均十分显著（P〈0．01）；western blot结果显示：细胞色素P4502E1在正常大鼠肝组织中有表达，染毒3h后表达增强，12h达到高峰，明显高于正常对照组（P〈0．05），其表达趋势与ROS浓度变化相一致。结论细胞色素P4502E1蛋白在大鼠急性肝损伤时表达显著增强，提示其在中毒性肝损伤的发病中可能具重要的病理生理意义，并与四氯化碳诱导的氧化应激反应密切相关。     

The ratio of aspartate aminotransferase to alanine aminotransferase: potential value in differentiating nonalcoholic steatohepatitis from alcoholic liver disease

OBJECTIVE: The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is often greater than 2:1 in alcoholic hepatitis. The purpose of this study was to determine whether this ratio may be used to distinguish nonalcoholic steatohepatitis (NASH) from alcoholic liver disease. METHODS: Patients with NASH were matched with controls with alcoholic liver disease based on age, gender, and date of diagnosis. The diagnosis of alcoholic liver disease was based on exclusion of other causes and a significant history of alcohol consumption. The diagnosis of nonalcoholic steatohepatitis was based on exclusion of other causes of liver disease and a liver biopsy showing > 10% steatosis and inflammation. The two sided Student t test was used for statistical analysis. RESULTS: From 1990 to 1996, 70 patients with NASH were matched with 70 subjects with alcoholic liver disease. Patients with NASH had a mean AST to ALT ratio of 0.9 (range 0.3-2.8, median 0.7) and subjects with alcoholic liver disease a mean ratio of 2.6 (range 1.1-11.2, median 2.0). The mean AST levels were 66 U/L and 152 U/L, and the mean ALT levels 91 U/L and 70 U/L, in the nonalcoholic steatohepatitis and alcoholic liver disease groups, respectively. Although the absolute aminotransferase levels were significantly different in the two groups (p < 0.05), the greatest difference was observed in the AST to ALT ratio (p < 0.000001). Subset analysis of patients with NASH revealed mean AST to ALT ratios of 0.7, 0.9, and 1.4 for subjects with no fibrosis, mild fibrosis, or cirrhosis, respectively. The differences among these ratios were statistically significant (p < 0.05). CONCLUSIONS: The AST to ALT ratio appears to be a useful index for distinguishing nonalcoholic steatohepatitis from alcoholic liver disease. Although values < 1 suggest NASH, a ratio of > or = 2 is strongly suggestive of alcoholic liver disease.     

细胞色素P450 2E1在脂肪性肝炎大鼠肝组织的表达及作用

目的探讨细胞色素P4502E1(CYP2E1)在脂肪性肝炎大鼠肝组织内的表达和作用。方法通过高脂饮食和逐渐增加酒精灌胃量持续16周建立Wister大鼠脂肪性肝炎动物模型,造模结束时检测模型组和正常组动物血脂、游离脂肪酸(FFA)和肝组织丙二醛(MDA)、超氧化物歧化酶(SOD)、还原性谷胱甘肽(GSH)含量;免疫组化标记检测肝组织CYP2E1表达;RT-PCR法检测CYP2E1 mRNA的水平。结果实验结束时,模型组大鼠血脂和血清FFA较正常组显著增高(P<0.01);肝组织MDA较正常组显著增高(P<0.01),而SOD和GSH较正常组明显减低(P<0.01);肝组织内CYP2E1及其基因表达较正常组显著升高(P<0.01),并与肝组织内MDA、脂肪变程度、炎症计分呈明显正相关(r值分别为0.652,0.913和0.943,P值均<0.05),与SOD、GSH呈显著负相关(r值分别为-0.916,-0.766,P<0.01)。结论脂肪性肝炎大鼠肝脏内CYP2E1呈诱导表达状态,后者可能通过增强氧应激,降低抗氧化能力,加重脂质过氧化等过程参与了脂肪性肝炎的形成。     

Effect of lactulose on establishment of a rat non-alcoholic steatohepatitis model

AIM: To explore the relationship between changes of intestinal environment and pathogenesis of non-alcoholic steatohepatitis (NASH). METHODS: Forty-two Sprague-Dawley rats were randomly divided into model group (n = 24), treatment group (n = 12), and control group (n = 6). The rats of model and treatment groups were given high-fat diet, and those of the control group were given normal diet. Furthermore, the rats of treatment group were given lactulose after 8 wk of high-fat diet. Twelve rats of the model group were killed at 8 wk of high-fat diet. At the 16 wk the rats of treatment group, control group, and the rest of the model group were killed. The serum levels of aminotransferase were measured and the histology of livers was observed by H&E staining. RESULTS: The livers of rats presented the pathological features of steatohepatitis with higher serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the model group after 16 wk. Compared to the model group, the serum levels of ALT and AST in treatment group decreased significantly and were close to the normal group, and the hepatic inflammation scores also decreased markedly than those in the model group after 16 wk (5.83±2.02 vs3.63±0.64, P<0.05), but were still higher than those in the model group after 8 wk (3.63±0.64 vs 1.98±0.90, P<0.05). However, the degree of hepatic steatosis had no changes in treatment group compared to the model group after 16 wk. CONCLUSION: Lactulose could ameliorate the hepatic inflammation of rats with steatohepatitis induced by fat-rich diet, but could not completely prevent the development of steatohepatitis. It is suggested that intestinal environmental changes such as intestinal bacteria overgrowth, are one of the important factors in the pathogenesis of NASH.     

Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin e in nonalcoholic steatohepatitis.

BACKGROUND & AIMS: Nonalcoholic steatohepatitis (NASH) is a frequent liver disease that can progress to cirrhosis and for which there is no recognized therapy. UDCA and vitamin E have been considered separately as therapeutic options and have not been shown to be effective. This study tested their combination. METHODS: Patients with elevated aminotransferase levels and drinking less than 40 g alcohol/week with biopsy-proven NASH were randomly assigned to receive UDCA 12-15 mg.kg-1.day-1 with vitamin E 400 IU twice a day (UDCA/Vit E), UDCA with placebo (UDCA/P), or placebo/placebo (P/P). After 2 years, they underwent a second liver biopsy. Biopsy specimens were collected, blinded, and scored by a single liver pathologist. RESULTS: Forty eight patients were included, 15 in the UDCA/Vit E group, 18 in the UDCA/P group, and 15 in the P/P group; 8 patients dropped out, none because of side effects. Baseline parameters were not significantly different between the 3 groups. Body mass index remained unchanged during the study. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels diminished significantly in the UDCA/Vit E group. Neither the AST nor the ALT levels improved in the P/P group and only the ALT levels in the UDCA/P group. Histologically, the activity index was unchanged at the end of the study in the P/P and UDCA/P groups, but it was significantly better in the UDCA/Vit E group, mostly as a result of regression of steatosis. CONCLUSIONS: Two years of treatment with UDCA in combination with vitamin E improved laboratory values and hepatic steatosis of patients with NASH. Larger trials are warranted.     

Amelioration of Steatohepatitis with Pentoxifylline in a Novel Nonalcoholic Steatohepatitis Model Induced by High-Fat Diet

We sought to evaluate the effects of pentoxifylline (PTX) on steatohepatitis in a novel experimental nonalcoholic steatohepatitis (NASH) model induced by a high-fat diet (HFD). Thirty-three male Sprague-Dawley rats were randomly divided into 3 groups. The first group received only standard rat diet (control group); groups 2 (placebo group) and 3 were given HFD, ad libitum. After week 4, 0.5 mL of physiologic serum was injected subcutaneously to the placebo group and 50 mg/kg/d PTX was given intraperitoneally to the third group (group PTX). After 6 weeks all rats were humanely killed. Serum biochemistry, tumor necrosis factor-α (TNF-α), plasma, and liver tissue malondialdehyde (MDA) were analyzed. Histopathologically, steatosis, ballooning degeneration, inflammation, and fibrosis were determined. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, plasma and liver tissue MDA, and plasma TNF-α levels were significantly higher in placebo group than in the control group. Tumor growth factor-β levels, however, were comparable in the placebo and control groups. On histopathologic examination, steatosis, inflammatory cells per square millimeter, and ballooning degeneration were significantly higher in the placebo group than in the control group. No fibrosis or Mallory bodies were found in the placebo group. AST, ALT, plasma and liver tissue MDA, and plasma TNF-α levels were significantly lower in PTX group compared to the placebo group. Histopathologically, steatosis, mean number of inflammatory cells/mm² and ballooning degeneration in PTX group were also significantly lower than in the placebo group. In conclusion, PTX strikingly ameliorates steatohepatitis in this novel NASH model not only by inhibiting the TNF-α but also suppressing the oxidative stress markers.     

Non-alcoholic steatohepatitis with normal aminotransferase values

AIM： To investigate the aspects of liver histology in patients with non-alcoholic steatohepatitis （NASH） who had normal aminotransferase levels. METHODS： Thirty-four patients diagnosed with liver steatosis by ultrasonographic examination participated in the study. We compared all non- alcoholic fatty liver disease and NASH cases, according to aminotransferase level, aspartate aminotransferase （AST）/alanine aminotransferase （ALT） ratio and presence of metabolic syndrome. RESULTS： Sixteen of 25 patients with high aminotransferase levels were diagnosed with NASH and nine with simple fatty liver according to liver histology. Among the nine patients with normal aminotransferase levels, seven had NASH and two had simple fatty liver. The patients with normal and high liver enzyme levels had almost the same prevalence of NASH and metabolic syndrome. Liver histology did not reveal any difference according to aminotransferase levels and AST/ALT ratio. CONCLUSION： Aminotransferase levels and AST/AIT ratio do not seem to be reliable predictors for NASH. Despite numerous non-invasive biomarkers, all patients with fatty liver should undergo liver biopsy.     

攻毒扶正法对非酒精性脂肪性肝炎大鼠瘦素、胰岛素的影响

目的：观察攻毒扶正法对非酒精性脂肪性肝炎（NASH）大鼠瘦素（LEP）、胰岛素（INS）的影响。方法：用高脂饲料与四氯化碳（CCl4）制备NASH大鼠模型,分别用乙肝系列中成药（乙肝清热解毒颗粒、乙肝益气解郁颗粒、乙肝养阴活血颗粒）、辛伐他丁溶液进行灌胃。分为正常组,模型组,辛伐他丁组,清热解毒组,益气解郁组,养阴活血组,清热解毒合益气解郁组（简称清解合益气组）,清热解毒合养阴活血组（简称清解合养阴组）共8组,每组12只。用药4周后显微镜下观察NASH大鼠肝脏HE染色切片,并对肝组织病变程度评分。检测肝功能、血脂、LEP、INS情况。结果：模型组肝组织病变程度评分明显高于正常组（P〈0.01）,丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）升高,总胆固醇（TCh）升高明显（P〈0.01）,LEP、INS水平均升高（P〈0.05）。治疗组均可降低LEP水平,肝组织病变评分降低。中药组的ALT、AST、TC、LEP、INS含量有下降趋势（P〈0.05或〈0.01）;辛伐他丁组能降低ALT、INS含量,差异无显著性意义。结论：NASH大鼠体内有明显LEP、INS水平升高趋势。各治疗组均能降低大鼠体内LEP、INS水平。通过各类指标的检测,中药组改善作用更为明显。证明攻毒扶正法治疗NASH大鼠有切实的作用。