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基于营养摄入状况的肝脏疾病营养治疗。

Nutrition therapy for liver diseases based on the status of nutritional intake.

机构信息

Department of Health and Nutrition Sciences, Faculty of Health and Social Welfare Sciences, Nishikyushu University, Kanzaki 842-8585, Japan ; Clinical Research Center, Kyushu Medical Center, National Hospital Organization, Fukuoka 810-0065, Japan.

出版信息

Gastroenterol Res Pract. 2012;2012:859697. doi: 10.1155/2012/859697. Epub 2012 Nov 14.

Abstract

The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake; hence, nutritional support is also required during therapy to prevent undernourishment, treatment interruption, and a reduction in quality of life. Moreover, addition of some nutrients that act to suppress viral proliferation is recommended. As a substitutive treatment, low-iron diet therapy, which is relatively safe and effective for preventing hepatocellular carcinoma, is also recommended for CHC patients. Some patients with liver cirrhosis (LC) have decreased dietary energy and protein intake, while the number of LC patients with overeating and obesity is increasing, indicating that the nutritional state of LC patients has a broad spectrum. Therefore, nutrition therapy for LC patients should be planned on an assessment of their complications, nutritional state, and dietary intake. Late evening snacks, branched-chain amino acids, zinc, and probiotics are considered for effective nutritional utilization.

摘要

非酒精性脂肪性肝病(NAFLD)患者的饮食摄入通常以高碳水化合物、脂肪和/或胆固醇为特征,这些饮食模式会影响患者的肝脂质代谢。因此,仔细调查饮食习惯可能会导致更好的 NAFLD 患者营养治疗。慢性丙型肝炎(CHC)的主要治疗方法是基于干扰素的抗病毒治疗,这种治疗常常会导致食欲下降和能量摄入减少;因此,治疗期间也需要营养支持,以防止营养不足、治疗中断和生活质量下降。此外,建议添加一些具有抑制病毒增殖作用的营养素。作为替代治疗,低铁饮食治疗对于预防肝细胞癌相对安全有效,也推荐用于 CHC 患者。一些肝硬化(LC)患者的饮食能量和蛋白质摄入减少,而 LC 患者中过度饮食和肥胖的人数正在增加,这表明 LC 患者的营养状况具有广泛的范围。因此,应根据 LC 患者的并发症、营养状况和饮食摄入情况来计划营养治疗。夜间加餐、支链氨基酸、锌和益生菌被认为可以有效利用营养。

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