关键词: 非酒精性脂肪性肝炎；　纤维化；　炎症

Abstract: 　Objective　To investigate the clinical and pathological features of non-alcoholic steatohepatitis (NASH) in children, and the clinical value of non-invasive diagnosis of inflammation and hepatic fibrosis by transaminase and APRI, FIB-4 index. Methods　The clinical and pathological characteristics of 34 children with NASH were retrospectively analyzed. According to the clinical indexes, the results of APRI and FIB-4 index were obtained, and the results of liver pathology were regarded as gold standard. The correlation of alanine aminotransferase, aspartate aminotransferase and APRI, FIB-4 index with the degree of inflammation and fibrosis in children with NASH was analyzed. Results In 34 children (32 males and 2 females) with NASH, 32 cases had central obesity. The disease course was ranging from 1 day to 6 years. Abdominal circumference fluctuated from 77 cm to 101 cm. The level of aminotransferase was elevated in all the patients, except for 2 patients with no obesity, and all the children had normal glycosylated hemoglobin and fasting blood glucose. There were 9 cases complained with metabolic syndrome, 4 cases with hypertension, 11 cases with hyperuricemia, 15 cases with dyslipidemia, 15 cases with insulin resistance, 27 cases with occult penis and 20 cases with sleep apnea. Ultrasonography showed fatty liver in 25 children. Liver biopsy showed that the majority of the children were G2S1. Grading of inflammation showed that there were 11 cases of G1, 22 cases of G2 and 1case of G3. Fibrosis grade showed that there were 3 cases of S0,18 case of S1, 9 case of S2, 3 cases of S3, and 1 case of S4. There was no correlation between alanine aminotransferase, aspartate aminotransferase and the degree of inflammation in liver biopsy (P>0.05). There was no correlation between the APRI index and the degree of hepatic fibrosis (P>0.05), but the FIB-4 index (r=0.396, P<0.05) was correlated with the degree of hepatic fibrosis. Conclusion　Children with NASH were prone to being complicated with metabolic syndrome, insulin resistance, increased uric acid, sleep apnea and occult penis. The liver biopsy indicated that most of the children were G2S1.The FIB-4 index was correlated with the degree of liver fibrosis.

Key words: 　non-alcoholic steatohepatitis;　fibrosis;　inflammation