自身免疫性肝损伤与非酒精性脂肪性肝病

自身免疫性肝病(AILD)和非酒精性脂肪性肝病(NAFLD)是两大类造成肝功能进行性损害的慢性炎症性肝脏疾病,两者均缺乏特征性临床表现和生化指标。近年来,随着生活方式的改变,肥胖和NAFLD在全球呈流行趋势,AILD中的自身免疫性肝炎(AIH)和原发性胆汁性肝硬化(PBC)可呈现与NAFLD"共存"的现象,使诊断更为困难。已确诊的NAFLD患者如出现不明原因的肝功能恶化,应考虑并发AILD的可能。本文对"NAFLD-AILD共存"的临床病理特点作一概述,并初步探讨其可能机制。

Autoimmune Liver Injury and Non-alcoholic Fatty Liver Disease

Autoimmune liver disease （AILD） and non-alcoholic fatty liver disease （NAFLD） are two major types of chronic inflammatory liver diseases that lead to progressive decline of liver function. Both of them are lack of characteristic clinical symptoms and biochemical parameters. As the worldwide popularity of Western lifestyle and the global trend of obesity and NAFLD, autoimmune hepatitis （AIH） and primary biliary cirrhosis （PBC） would be co-existence with NAFLD, which makes the diagnosis more difficult. When the patients have definite NAFLD and unexplained liver function deterioration, the possibility of concurrent AILD should be taken into account. This article summarized the clinical and pathologic features of ＂NAFLD-AILD co-existence＂ and explored its possible mechanism.