Roeb E
Gastroenterologie Justus-Liebig-Universität Gießen, Gießen, Deutschland.
Zentralbl Chir. 2014 Apr;139(2):168-74. doi: 10.1055/s-0031-1283813. Epub 2012 Mar 22.
Non-alcoholic steatohepatitis (NASH) was first described in 1980 and has emerged from an anecdotal disease to a widely distributed liver disease in the current decade.
This review is based on publications in PubMed and our own experiences and deals with basic pathophysiological aspects, diagnostic, and therapeutic tools as well as with the modern management of this serious liver disease.
For a long time the potenial for serious liver destruction and enhanced liver mortality by NASH has been observed. The recognition of the metabolic origin of NASH has contributed to diagnostic as well as therapeutic approaches. Since then patients with metabolic syndrome are often screened for liver disease. NASH might worsen other chronic liver diseases but should be judged as an independent illness rather than the exclusion of other potential liver diseases. Furthermore, non-alcoholic steatohepatitis has systemic consequences concerning insulin resistance, metabolic complications and cardiovascular diseases.
Future research should concentrate on non-invasive screening strategies, identification of risk factors, evaluation of hepatocellular carcinogenesis and new therapeutic targets.
非酒精性脂肪性肝炎（NASH）于1980年首次被描述，在过去十年中已从一种罕见疾病发展成为一种广泛流行的肝脏疾病。
本综述基于PubMed上的出版物以及我们自己的经验，涉及基本病理生理学方面、诊断和治疗工具，以及这种严重肝脏疾病的现代管理。
长期以来，人们已经观察到NASH导致严重肝脏破坏和肝脏死亡率增加的可能性。对NASH代谢起源的认识推动了诊断和治疗方法的发展。从那时起，代谢综合征患者经常接受肝病筛查。NASH可能会使其他慢性肝病恶化，但应将其视为一种独立疾病，而不是排除其他潜在肝病。此外，非酒精性脂肪性肝炎在胰岛素抵抗、代谢并发症和心血管疾病方面具有全身性影响。
未来的研究应集中在非侵入性筛查策略、危险因素的识别、肝细胞癌发生的评估以及新的治疗靶点上。
