Gossard A A, Lindor K D
Mayo Clinic, Rochester, Minnesota 55901, USA.
Drugs Today (Barc). 2011 Dec;47(12):915-22. doi: 10.1358/dot.2011.47.12.1688530.
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in adults and children in many regions of the world. Although a relatively benign condition in some, for others the disease will progress to cirrhosis and end-stage liver disease with associated complications including hepatocellular cancer. Pharmaceutical therapies have had mixed results and none are accepted as standard therapy. Depending on the metric used to assess response (biochemical or histological), there are some therapies which may afford benefit. Others, however, have caused less than desirable adverse effects. Unfortunately, no particular treatment has emerged as safe and highly effective. The cornerstones of management of this problematic condition should include exercise and efforts at weight reduction through dietary changes and increased physical activity. Weight reduction does indeed seem to be beneficial in this setting, as evidenced by studies including those evaluating the effect of bariatric surgery. Less is known, however, about the effort of exercise in and of itself as a treatment strategy, even in the absence of a reduction in body weight. In this paper, we review the literature pertaining to the current state of NAFLD management with an emphasis on pharmacotherapy.
非酒精性脂肪性肝病（NAFLD）是世界许多地区成人和儿童慢性肝病最常见的病因之一。虽然在某些人身上这是一种相对良性的疾病，但对另一些人来说，该疾病会进展为肝硬化和终末期肝病，并伴有包括肝细胞癌在内的相关并发症。药物治疗效果不一，且尚无一种被公认为标准疗法。根据用于评估反应的指标（生化或组织学），有些疗法可能有益。然而，其他一些疗法却产生了不尽如人意的不良反应。不幸的是，尚未出现安全且高效的特定治疗方法。对于这种疑难病症的管理基石应包括运动以及通过饮食改变和增加体力活动来努力减轻体重。体重减轻在这种情况下确实似乎有益，包括那些评估减肥手术效果的研究都证明了这一点。然而，即便在体重没有减轻的情况下，关于运动本身作为一种治疗策略的作用，人们了解得还较少。在本文中，我们综述了有关NAFLD管理现状的文献，重点是药物治疗。
