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非酒精性脂肪性肝炎:文献综述与管理更新

Nonalcoholic steatohepatitis: a review of the literature and updates in management.

作者信息

Pasumarthy Lakshmi, Srour James

机构信息

Department of Medicine and Gastroenterology, York Hospital, York, PA 17405, USA.

出版信息

South Med J. 2010 Jun;103(6):547-50. doi: 10.1097/SMJ.0b013e3181de0ce0.

Abstract

Nonalcoholic steatohepatitis is a common cause of liver inflammation and is associated with obesity, insulin resistance, and hyperlipidemia. There are concerns that it may turn out to be the most common cause of liver failure as prevalence of obesity increases. It leads to increased morbidity and mortality. Other causes of liver inflammation, especially alcoholic liver disease, must be ruled out. The diagnosis is suggested by abnormalities in the blood work and metabolic panel in an obese patient. Despite advances made in our understanding regarding the pathogenesis and trials with multiple drugs targeting mechanisms in pathogenesis, there are no consistent guidelines regarding treatment. However, multiple sources advocate weight reduction, optimum blood glucose control, and elimination of medications that cause fatty infiltration. The purpose of our article is to detail advances made in identifying disease mechanisms and treatment modalities, including surgery to promote weight loss.

摘要

非酒精性脂肪性肝炎是肝脏炎症的常见原因,与肥胖、胰岛素抵抗和高脂血症相关。随着肥胖患病率的增加,人们担心它可能会成为肝衰竭最常见的原因。它会导致发病率和死亡率上升。必须排除肝脏炎症的其他原因,尤其是酒精性肝病。肥胖患者血液检查和代谢指标异常提示该诊断。尽管我们对发病机制的理解有所进展,并且针对发病机制进行了多种药物试验,但在治疗方面尚无一致的指南。然而,多个来源都主张减轻体重、优化血糖控制以及停用导致脂肪浸润的药物。我们文章的目的是详细阐述在确定疾病机制和治疗方式方面取得的进展,包括促进体重减轻的手术。

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