Hagymási Krisztina, Lengyel Gabriella
Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088.
Orv Hetil. 2010 Nov 21;151(47):1940-5. doi: 10.1556/OH.2010.28989.
Non-alcoholic steatosis/steatohepatitis is the most common etiology of abnormal liver function tests. Authors review the etiology, pathomechanism and clinical signs. Possibilities of the diagnosis are also summarized. There is an increasing need to find non-invasive biomarkers (TNF-α, adiponektin, end product of lipid peroxidation, cytokeratin-18, hyaluronic acid), score systems (Fibrotest, APRI), methods (Fibroscan), which would detect the progression of the disease, the development of inflammation and fibrosis. There is no proven specific therapy; the aim is the elimination of provoking factors (weight loss), treatment of diabetes mellitus and hyperlipidemia. Besides, liver protection (antioxidants) is important, as well.
非酒精性脂肪变性/脂肪性肝炎是肝功能检查异常最常见的病因。作者回顾了其病因、发病机制和临床症状。还总结了诊断的可能性。越来越需要找到非侵入性生物标志物(肿瘤坏死因子-α、脂联素、脂质过氧化终产物、细胞角蛋白-18、透明质酸)、评分系统(Fibrotest、APRI)、方法(Fibroscan),以检测疾病的进展、炎症和纤维化的发展。目前尚无经证实的特异性治疗方法;目标是消除诱发因素(减肥)、治疗糖尿病和高脂血症。此外,肝脏保护(抗氧化剂)也很重要。