内科理论与实践2017，Vol.12Issue(4)：256-261,6.DOI:10.16138/j.1673-6087.2017.04.006
代谢性手术治疗重度肥胖伴非酒精性脂肪性肝病患者的疗效观察
Effect of metabolic surgery in treatment of severe obesity with nonalcoholic fatty liver disease
摘要
Abstract
Objective To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on severe obesity with nonalcoholic fatty liver disease (NAFLD) and metabolic derangement.Methods Retrospective analysis was performed on 108 severely obese patients with NAFLD undergoing LSG in Shanghai Tenth People's Hospital,Tongji University Medical School from December 2012 to June 2017.Of them 66 were females and 42 were males,with an average age of (32.5± 10.5) years old and an average body mass index of 39.2±5.2.The anthropometric indexes,glucose metabolic indices and insulin secretion level,lipid profile,liver enzymes [alanine aminotransferase (ALT),aspartate aminotransferase (AST),and γ-glutamyltransferase (GGT)] and fatty liver were examined preoperatively and 1,3,6 and 12 months postoperatively.Data before and after surgery were compared using paired-sample t test.Results At 1-12 months after operation,the anthropometric indexes,total cholesterol (TC),triglyceride (TG),fasting insulin (FINS),homeostasis model assessment-insulin resistance index (HOMA-IR) and hemoglobin A1e (HbA1c) levels were significantly decreased compared with those before surgery(P＜0.05).At 3 months after surgery,high density lipoprotein-cholesterol (HDL-C) level increased significantly and fasting plasma glucose (FPG) decreased significantly.At 12 months after surgery,low density lipoprotein-cholesterol (LDL-C) level was significantly lower than that before surgery(P＜0.05).In addition,for those with abnormal liver function(n=63),the ALT,AST,and GGT levels had complete recovery 3 months after LSG.One year after LSG,20 of those who completed 1 year follow up obtained complete remission of fatty liver,and most patients obtained significant improvement.Conclusions LSG not only can decrease weight effectively,but also can improve NAFLD,liver function,and glycolipid metabolism significantly.关键词
腹腔镜下袖状胃切除术/肥胖症/非酒精性脂肪性肝病/肝功能异常Key words
Sleeve gastrectomy/Obesity/Nonalcoholic fatty liver disease/Abnormal liver function分类
医药卫生引用本文复制引用
朱翠玲,钱春花,张怡,高晶扬,尤慧,卢列盛,董恒生,周东雷,曲伸..代谢性手术治疗重度肥胖伴非酒精性脂肪性肝病患者的疗效观察[J].内科理论与实践,2017,12(4):256-261,6.基金项目
国家自然科学基金项目(项目编号:81570782、81500650、81700752) （项目编号:81570782、81500650、81700752）
