非酒精性脂肪肝病研究进展

非酒精性脂肪肝病(NAFLD)和非酒精性脂肪肝炎(NASH)的发生与肥胖、2型糖尿病、胰岛素抵抗(IR)、脂代谢异常等有关。肝脏脂联素活性降低、脂联素受体-Ⅱ表达减少以及瘦素抵抗导致NAFLD。肝脏IR、反应氧族(ROS)产生增多以及抗氧化防御机制受损是NASH发生的中心环节。TNF-α、IL-6水平升高诱导IR和肝纤维化发生。减轻体重是预防肥胖者发生NAFLD的基本措施,细胞保护剂、抗氧化剂和降脂药物对NASH有一定治疗作用,噻唑脘二酮类(如罗格列酮)的临床治疗研究已取得可喜的疗效。今后有待进一步研制肝毒性小的能减轻肝脏脂肪蓄积和纤维化的药物。

Progression on Study of non-alcoholic fatty liver disease

The obesity, diabetes mellitus type II, insulin resistance(IR)and abnormal metabolism of lipid are involved in pathogenesis of non-alcoholic fatty liver disease(NAFLD) and non-alcoholic steatohepatitis.Decreased adiponectin activity, lower expression of adiponectin receptor II and leptin resistance result in the pathogenesis of NAFLD. The principal factors of occurrence NASH have IR, increased volume of responsive oxygen seriese(ROS) and descented antioxidative defence mechanism in liver. Elevated levels of IL-6 and TNF-α may induce the liver fibrosis. Weight reduction is principal measure for prevent from NAFLD in obesity patients. The cytoprotective agents, antioxidants and medicine of lower blood fat possesess some therapeutical effect for NASH patients. The clinical study on euglycemic agent (as thiazolidinediones) for NASH have gained delectable curative effect.It is expected that developing medicine with less hepatotoxicity and lighten fibrosis and lipopexia in the future.