Abstract:
Objective:To explore the hepatic histological changes in patients with nonalcoholic steatohepatitis (NASH) after comprehensive treatment.Methods:Inpatients who were diagnosed as NASH and received hepatic pathological examination again after comprehensive treatment were enrolled from January 2011 to November 2018 in Zhongshan Hospital, Fudan University. The comprehensive treatments and the changes in hepatic histological examination were analyzed.Results:A total of 10 patients (2 males and 8 females) with the age of (54.2±9.6) years old, were enrolled in the study. Among all the patients, 8 were complicated with abnormal glucose metabolism, 6 had hypertension, 4 had remission, and 4 had hypothyroidism. After 1.04 (0.73, 1.54) years of treatments, 80% (8/10) of the patients had improvement of NASH. The total score of NASH decreased by 1 (0.5, 3.5) point, and the grade of liver fibrosis decreased by 1 (0.5, 1.5) point. Only 2 patients had progression of NASH. After treatments, the body mass index (BMI) decreased significantly. Meanwhile, HbA1c, alanine aminotransfase, aspartate aminotransferase, and γglutamyl transpeptidase decreased (P<0.05). In the patients with remission of NASH, the weight loss was more significant (10.80% [8.62%,20%]), and the blood pressure was controlled at the level of (128.14±8.8)/(83.14±7.47) mmHg (1 mmHg=0.133 kPa). In patients with progression of NASH, no significant weight loss was observed and blood pressure was poorly controlled.Conclusions:Comprehensive treatments can ameliorate hepatic pathological changes in most NASH patients, which may be related to weight loss and blood pressure control.