133 李学军 1 孙倩 2 (1. 361003; 2. 2013 361002) : ; ; :R575.5 DOI:10.3969/j.issn.1671-2870.2014.02.006 :A :1671-2870(2014)02-0133-05 NASH [5] (non-alcoholic fatty liver diseasenafld) NAFLD (non-alcoholic steatohepatitisnash) NASH NASH NASH [2] NASH 10%~15% NASH [3] [2 4] NAFLD (body mass indexbmi) NASH NAFLD NASH NASH 20% NAFLD NASH NAFLD 1 (alanine transarninasealt) ;2 (aspartate transaminaseast) ;3 γ- ; 4 ALT NASH ALT ; NASH ( 79%) ALT [6] ( ) Fas ( 80 ALT ) NASH 58 (72.5%) NASH NASH NASH NASH NASH [7] 26 8
134 J Diagn Concepts Pract 2014 Vol.13 No.2 1. : NASH( 0.906 82% NAFLD NASH 88%) hs-crp 1Th1 Th2 α(tumor [1 17] 18 NASH necrosis factor αtnf-α) 1(interleukin-1 IL-1) IL-6 IL-18 ;2 CC (C ) CC 2 ( CCL2 )/ [18] 1 CCL19 CCL21 T (RANTES);3 ( ) [19] NASH NASH NASH -18 TNF-α/ NASH TNF-α ob/ob NASH 0.76~0.88 NAFLD [20] IL-6-3 [8] NASH IL-6 NASH NASH Fas -18 NASH [9] IL-6 IL-6 NASH IL-6 [10] 3. : NASH NASH Logistic NASH IL-6> 4.81 pg/ml [OR=33.795% 1.7~ [23-24] 680.7P 0.022] NASH [11] NASH TNF-α NAFLD Abiru [10] NASH TNF-α TNF 1(sTNFR1) NAFLD NASH TNF-αmRNA TNF-α ALT mrna 100 ng/ml NASH ( 0.685 160 13 66.7% 74.1%) [12] TNF-α NASH α 2 A1 γ- [25] ALT AST NASH TNF-α NASH [13-15] NAFLD C (C- reaction proteincrp) BMI 6 3 3 CRP NAFLD CRP 0.5 mg/l NASH (16 ) CRP CRP 2. : 0.8295% [21-22] NASH test(biopredictive) 0.78 NASH test 97 Palekar [26] NASH 6 [16] CRP 50 BMI 30 kg/m 2 AST 45 u/ L NASH AST/ALT 0.8 (hyaluronic acid
135 HA) 55 μg/l NASH CRN NASH 3 [27] [35] AST ALT AST/ALT Kalhan [36] ( ) NASH ( 2 ) NAFLD NASH 0.79 (95% 0.76~0.83) CT MRI NASH NAFLD NASH NAFLD [28] MRI NASH MRI MRI E ( - 1-2 - 3 ) MRI [29] CT MRI 3 CT 1 α- ; 2 ; [30] CT 3 ( B ) NASH CT [37] E E 800 u/d NASH E E [31] NASH E [29] NASH NASH PNPLA3 NAFLD [32-33] Younossi [34] NAFLD 12 NASH
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