腹腔镜下袖状胃切除术治疗非酒精性脂肪性肝病患者改善糖脂代谢紊乱

目的 研究腹腔镜下袖状胃切除术(LSG)治疗非酒精性脂肪性肝病(NALFD)患者对糖脂代谢的影响。方法 2016年5月～2018年8月安徽医科大学第二附属医院减重中心收治的73例肥胖合并NALFD患者,接受LSG手术。随访半年。结果 在73例NAFLD患者中,男性36例,女性37例,平均年龄为(31.7±7.4)岁;术后半年体质量和体质指数(BMI)分别 为(89.0±16.4)Kg和(31.1±4.4) kg/m²,显著低于术前【分别为(120.0±23.5)kg和(42.2±6.7)kg/m², P< 0.01)】;术后半年血清谷丙转氨酶、谷草转氨酶、碱性磷酸酶和谷氨酰转肽酶分别为(28.6±11.3) U/L、(19.3±8.6) U/L、(67.2±15.8) U/L和(27.5±13.1) U/L,显著低于术前【分别为(61.4±23.2) U/L、(37.3±12.3) U/L、(83.2±21.3) U/L和(54.4±17.2) U/L,P< 0.01】;术后半年空腹血糖、甘油三脂和总胆固醇分别为(5.1±0.6)mmol/L、(1.0±0.5)mmol/L和(4.3±1.0)mmol/L,较术前【(6.0±1.7)mmol/L、(1.7±0.9)mmol/L和(4.7±1.6)mmol/L 】显著降低(P< 0.05)。结论 LSG手术可以显著降低肥胖伴NAFLD患者体质量,改善血清肝酶异常和糖脂代谢紊乱。

Laparoscopic sleeve gastrectomy improves liver enzyme and glycolipid metabolism disorders in obese persons with nonalcoholic fatty liver disease

Objective The aim of this study was to investigate whether laparoscopic sleeve gastrectomy(LSG)might improve liver enzyme and glycolipid metabolism disorders in obese persons with nonalcoholic fatty liver disease(NALFD).Methods 73 obese persons with NALFD were admitted to our Department of General Surgery,Second Affiliated Hospital,from May 2016 through August 2018,and all underwent LSG.The patients were followed-up for six months.Results Out of all the patients,36 were male and 37 were female,with an average age of(31.7±7.4)years;the body weight and body mass index(BMI)at the end of six months after operation were(89.0±16.4)kg and(31.1±4.4)kg/m 2,significantly lower than(120.0±23.5)kg and(42.2±6.7)kg/m 2 before the surgery(P<0.01);serum alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and glutamyl aminotransferase levels were(28.6±11.3)U/L,(19.3±8.6)U/L,(67.2±15.8)U/L and(27.5±13.1)U/L,significantly lower than(61.4±23.2)U/L,(37.3±12.3)U/L,(83.2±21.3)U/L and(54.4±17.2)U/L,respectively,before surgery(P<0.01);serum fasting blood glucose,triglyceride and total cholesterol levels were(5.1±0.6)mmol/L,(1.0±0.5)mmol/L and(4.3±1.0)mmol/L,significantly lower than(6.0±1.7)mmol/L,(1.7±0.9)mmol/L and(4.7±1.6)mmol/L,respectively,before surgery(P<0.05),while serum albumin and total bilirubin levels were(42.9±2.8)g/L and(10.9±4.9)μmol/L,not significantly different as compared to(42.8±4.2)g/L and(11.0±5.2)μmol/L,respectively,before surgery(P>0.05).Conclusion LSG surgery could improve liver enzyme and glycolipid metabolism disorders in obese persons with NAFLD,which needs further and long-term investigation.