中文摘要：

目的：研究非酒精性脂肪性肝炎（NASH）患者网膜脂肪及皮下脂肪巨噬细胞数量的变化。方法选择NASH伴单纯性胆囊结石患者22例和单纯性胆囊结石患者28例。在腹腔镜手术中取肝组织、网膜脂肪组织和皮下脂肪组织。常规检测BMI、腹围、血糖、血酯、HOMA指数、胰岛素、游离脂肪酸；采用免疫组化法检测脂肪组织巨噬细胞。以抗CD68抗体标记巨噬细胞，抗CD11C标记M1亚群巨噬细胞，抗CD206抗体标记M2亚群巨噬细胞。结果 NASH患者血清AST （31.43±14.76）U/L对（23.68±9.64）U/L、TG （2.42±0.82）mmol/L对（1.65±0.47） mmol/L、胰岛素（83.18±44.34）mlu/L对（51.15±32.12）mlu/L和HOMA指数（21.00±14.75）对（12.43±10.66）显著高于胆囊结石患者（P＜0.05）；NASH患者网膜脂肪组织巨噬细胞数量为（34.41±15.35），皮下脂肪组织巨噬细胞数量为（27.91±11.13），而胆囊结石患者分别为（29.93±11.49）和（15.57±5.67），（P＜0.01）；在22例NASH患者中，其NAS评分7分2例，6分6例，5分9例，4分5例。NASH患者皮下脂肪组织巨噬细胞、M1亚群巨噬细胞和M2亚群巨噬细胞数量与NAS评分呈正相关（P＜0.01），但在网膜脂肪组织中三种细胞与NAS评分无显著性相关（P＆gt;0.05）。结论网膜脂肪及皮下脂肪中的巨噬细胞数量变化参与了NASH的发病过程。

英文摘要：

Objective To investigate the changes of macrophage counts in adipose tissues in patients with nonalcoholic steatohepatitis（NASH）. Method 22 patients with NASH and 28 with gallbladder stone were includ-ed in this study. The epiploic adipose tissues and subcutaneous adipose tissues during laparoscopic cholecystecto-my were obtained. We detected the clinical data as respect to age,gender,BMI,abdominal circumference,glucose, ALT,AST,total cholesterol （TG）,HOMA index,insulin and free fatty acids. The infiltration of macrophages （anti-CD68）,macrophage M1（anti-CD11C） and macrophage M2（anti-CD206）in epiploic and subcutaneous adipose tis-sues were assessed by immunohistochemical staining. Results The serum AST（31.43±14.76）U/L vs. （23.68± 9.64）u/L,TG（2.42±0.82）mmol/L vs.（1.65±0.47）mmol/L,insulin（83.18±44.34）mlu/Lvs. （51.15±32.12）mlu/L and HOMA-index（21.00±14.75） vs.（12.43±10.66）in patients with NASH were significantly higher than those in pa-tients with gallbladder stone（P〈0.05）;The counts of macrophages in epiploic and in subcutaneous adipose tissues （34.41±15.35）and（27.91±11.13）,respectively in patients with NASH were higher than those（29.93±11.49）and （15.57±5.67）,respectively,P〈0.01） in patients with gallbladder stone;The NAS scores were 7 in two,6 in six,5 in nine,and 4 in five cases out of the 22 patients with NASH;The counts of macrophages,M1 and M2 macrophages in subcutaneous adipose tissues in NASH patients were positively correlated to NAS scores（P〈0.01）, but not in epiploic adipose tissues（P＆gt;0.05）. Conclusion The infiltration of the macrophages and macrophage po-larization in epiploic and subcutaneous adipose tissues were associated with the development of NASH.