Dyson J K, Anstee Q M, McPherson S
Liver Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Liver Unit, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Postgrad Med J. 2015 Feb;91(1072):92-101. doi: 10.1136/postgradmedj-2013-100404rep.
Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the population in many developed countries. Between 10% and 30% of patients with NAFLD have non-alcoholic steatohepatitis (NASH) that can progress to cirrhosis. There are metabolic risk factors common to both NAFLD and cardiovascular disease, so patients with NASH have an increased risk of liver-related and cardiovascular death. Management of patients with NAFLD depends largely on the stage of disease, emphasising the importance of careful risk stratification. There are four main areas to focus on when thinking about management strategies in NAFLD: lifestyle modification, targeting the components of the metabolic syndrome, liver-directed pharmacotherapy for high risk patients and managing the complications of cirrhosis.
在许多发达国家,非酒精性脂肪性肝病(NAFLD)影响着多达三分之一的人口。10%至30%的NAFLD患者患有非酒精性脂肪性肝炎(NASH),后者可发展为肝硬化。NAFLD和心血管疾病存在共同的代谢危险因素,因此NASH患者发生肝脏相关和心血管死亡的风险增加。NAFLD患者的管理很大程度上取决于疾病阶段,这凸显了仔细进行风险分层的重要性。在考虑NAFLD的管理策略时,有四个主要方面需要关注:生活方式改变、针对代谢综合征的组成部分、对高危患者进行肝脏定向药物治疗以及处理肝硬化的并发症。