儿童非酒精性脂肪性肝炎的诊断与治疗及其对减肥手术的影响
Diagnosis and treatment of pediatric nonalcoholic steatohepatitis and the implications for bariatric surgery.
作者信息
Pardee Perrie E, Lavine Joel E, Schwimmer Jeffrey B
机构信息
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, and Rady Children's Hospital, San Diego, California CA 92103-8450, USA.
出版信息
Semin Pediatr Surg. 2009 Aug;18(3):144-51. doi: 10.1053/j.sempedsurg.2009.04.004.
Abstract
This review focuses on the diagnosis, risk factors, prevalence, pathogenesis and treatment of pediatric nonalcoholic steatohepatitis (NASH). NASH is a progressive form of nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children. The factors that account for differences between children with NASH and children with milder forms of NAFLD are unclear. The diagnosis of NASH requires interpretation of liver histology because no noninvasive markers predict the presence or severity of NASH. There is no proven treatment for NASH. Several clinical trials for NAFLD are in progress; however, clinical trials focusing on NASH are needed. Heightened physician awareness of NAFLD, NASH, and associated risk factors is important to identify and treat affected children.
摘要
本综述聚焦于儿童非酒精性脂肪性肝炎（NASH）的诊断、危险因素、患病率、发病机制及治疗。NASH是非酒精性脂肪性肝病（NAFLD）的一种进展形式，是儿童慢性肝病最常见的病因。导致NASH患儿与症状较轻的NAFLD患儿存在差异的因素尚不清楚。NASH的诊断需要对肝脏组织学进行解读，因为尚无无创性标志物可预测NASH的存在或严重程度。目前尚无经证实有效的NASH治疗方法。多项针对NAFLD的临床试验正在进行；然而，仍需要针对NASH的临床试验。提高医生对NAFLD、NASH及相关危险因素的认识，对于识别和治疗受影响的儿童至关重要。
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本文引用的文献
1
Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis.
Gastroenterology. 2008 Dec;135(6):1961-1971.e2. doi: 10.1053/j.gastro.2008.08.050. Epub 2008 Sep 3.
2
Metformin use in children with nonalcoholic fatty liver disease: an open-label, 24-month, observational pilot study.
Clin Ther. 2008 Jun;30(6):1168-76. doi: 10.1016/j.clinthera.2008.06.012.
3
Cardiovascular risk factors and the metabolic syndrome in pediatric nonalcoholic fatty liver disease.
Circulation. 2008 Jul 15;118(3):277-83. doi: 10.1161/CIRCULATIONAHA.107.739920. Epub 2008 Jun 30.
4
Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis.
Hepatology. 2008 Aug;48(2):442-8. doi: 10.1002/hep.22376.
5
Waist circumference correlates with liver fibrosis in children with non-alcoholic steatohepatitis.
Gut. 2008 Sep;57(9):1283-7. doi: 10.1136/gut.2007.142919. Epub 2008 Jan 24.
6
Non-alcoholic fatty-liver disease in pediatric populations.
J Pediatr Endocrinol Metab. 2007 Oct;20(10):1059-73. doi: 10.1515/jpem.2007.20.10.1059.
7
Short-term outcome in the first 10 morbidly obese adolescent patients in the FDA-approved trial for laparoscopic adjustable gastric banding.
J Pediatr Gastroenterol Nutr. 2007 Oct;45(4):465-73. doi: 10.1097/MPG.0b013e318063eef6.
8
Pathology of nonalcoholic fatty liver disease.
Am J Clin Pathol. 2007 Nov;128(5):837-47. doi: 10.1309/RTPM1PY6YGBL2G2R.
9
Definitive diagnosis and assessment of risk for nonalcoholic fatty liver disease in children and adolescents.
Semin Liver Dis. 2007 Aug;27(3):312-8. doi: 10.1055/s-2007-985075.
10
Initial experience with the adjustable gastric band in morbidly obese US adolescents and recommendations for further investigation.
J Pediatr Gastroenterol Nutr. 2007 Aug;45(2):240-6. doi: 10.1097/MPG.0b013e31805b82fb.
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