非酒精性脂肪性肝病与肾素-血管紧张素系统：对治疗的启示
Nonalcoholic fatty liver disease and the renin-angiotensin system: Implications for treatment.
作者信息
Paschos Paschalis, Tziomalos Konstantinos
机构信息
Paschalis Paschos, Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece.
出版信息
World J Hepatol. 2012 Dec 27;4(12):327-31. doi: 10.4254/wjh.v4.i12.327.
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the commonest liver disease in Western countries. Treatment of NAFLD is currently based on lifestyle measures and no effective pharmacologic treatment is available so far. Emerging evidence, mainly from animal studies, suggests that the renin-angiotensin-aldosterone system may be of major importance in the pathogenesis of NAFLD and indicates that angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) as a potentially useful therapeutic approach. However, data from human studies are limited and contradictory. In addition, there are few randomized controlled trials (RCTs) on the effects of ACE-I or ARB in patients with NAFLD and most data are from retrospective studies, pilot prospective studies and post hoc analyses of clinical trials. Accordingly, more and larger RCTs are needed to directly assess the effectiveness of ACE-I and ARBs in NAFLD.
摘要
非酒精性脂肪性肝病（NAFLD）是西方国家最常见的肝脏疾病。目前，NAFLD的治疗基于生活方式干预措施，到目前为止尚无有效的药物治疗方法。主要来自动物研究的新证据表明，肾素-血管紧张素-醛固酮系统可能在NAFLD的发病机制中起重要作用，并提示血管紧张素转换酶抑制剂（ACE-I）和血管紧张素受体阻滞剂（ARBs）可能是一种有用的治疗方法。然而，来自人体研究的数据有限且相互矛盾。此外，关于ACE-I或ARB对NAFLD患者影响的随机对照试验（RCT）很少，大多数数据来自回顾性研究、前瞻性试点研究以及临床试验的事后分析。因此，需要越来越多的RCT来直接评估ACE-I和ARBs在NAFLD中的有效性。
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