非酒精性脂肪性肝病的药物治疗新进展

非酒精性脂肪性肝病（Nonalcoholic fatty liver disease,NAFLD）是指除外酒精和其他明确的损肝因素所致的、以弥漫性肝细胞脂肪性变为主要特征的临床病理综合征,     

调脂药物在非酒精性脂肪肝中的作用

非酒精陛脂肪性肝病（nonalcoholic fatty liver disease,NAFLD）是代谢综合征（MS）在肝脏的表现,既是MS的早期表现,也是MS的预测指标。血脂异常参与胰岛素抵抗及MS的发生及发展,促进肝脂肪变,而肝脂增加进一步启动代谢紊乱、肝脏炎症及纤维化改变。调脂药物能够改善血脂紊乱,     

血清脂联素在非酒精性脂肪性肝病发病中的意义

目的:探讨血清脂联素在非酒精性脂肪性肝病(NAFLD)发病中的意义。方法:雄性SD大鼠30只,分为2组,每组15只,实验组采用高脂饮食制备大鼠NAFLD模型,并检测两组血清脂联素水平及相关指标,然后进行统计学分析。结果:实验组肝细胞脂肪变性及炎性程度明显高于对照组;对照组及实验组血清脂联素、甘油三酯、血糖及胰岛素抵抗(IR)差异有显著性;直线分析肝细胞脂肪变性与血清脂联素存在有显著相关性,且与血糖、甘油三酯、IR存在正相关。结论:高脂饮食方法可成功制备出NAFLD大鼠模型,血清脂联素水平下降是NAFLD发病的主要因素,其原因与糖、脂肪代谢障碍,IR程度提高有关。     

保肝抗炎药物在非酒精性脂肪性肝病治疗中的作用

非酒精性脂肪性肝病(NAFLD)的早期干预已获得大多数学者认同.保肝抗炎药物包括多烯磷脂酰胆碱、维生素E、水飞蓟素、熊去氧胆酸、甘草酸制剂和己酮可可碱等,是NAFLD综合治疗的重要组成部分.本文重点综述保肝抗炎药物的适用人群及常用药物的选用.多项临床研究提示,保肝抗炎药物町改善NAFLD患者的临床症状和血清氨基转移酶水平,但大多数保肝抗炎药物对肝脏纤维化进程的改善依据尚不足.     

非酒精性脂肪性肝病的药物治疗

<正>由于缺少有组织学终点以及远期并发症和死亡转归的随机对照研究,药物对非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的治疗效     

非酒精性脂肪性肝病的治疗进展

目的:探寻非酒精性脂肪性肝病(NAFLD)的治疗策略。方法:通过查阅国内、外NAFLD的治疗指南及相关文献,从肥胖指标、血生化、影像学、病理检查等方面入手,指出各种治疗方法的优缺点。结果:目前已经有许多的针对NAFLD的治疗性研究,包括生活方式的干预及各种药物治疗。各种治疗方法均有利有弊,但生活方式的干预疗效是肯定的。结论:NAFLD的治疗仍是一个世界性的挑战,目前尚无一个具体的治疗策略,需综合性个体化治疗;生活方式的干预可能是治疗的重点,减肥手术可能是重症患者的主要治疗措施。     

脂联素与非酒精性脂肪性肝病关系的研究进展

非酒精性脂肪性肝病(NAFLD)是一种与胰岛素抵抗(IR)和遗传易感密切相关的代谢应激性肝脏损伤,其病理学改变与酒精性肝病(alcoholic liver disease,ALD)相似,但患者无过量饮酒史,疾病谱包括非酒精性单纯性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)及其相关肝硬化和肝细胞癌[1,2]。其全球患病率高达20%,而且还在逐年增长,近年来我国的发病率也呈逐年上升趋势[3],因此对NAFLD发病机制及防治策略的研究     

非酒精性脂肪性肝病与氧化应激

非酒精性脂肪性肝病常与肥胖、2型糖尿病和高血压等代谢综合征并存,其与氧化应激的关系越来越受到关注.本文综述非酒精性脂肪性肝病的发病机制、氧化应激及其相关抗氧化剂的研究.     

儿童非酒精性脂肪性肝病

儿童非酒精性脂肪性肝病(Non -alcoholicfattyliverdiasase ,NAFLD)的临床问题逐渐受到关注。目前发现儿童的NAFLD与成人非酒精性脂肪性肝炎(Non -alcoholicsteatohepatitis,NASH)及其预后成正相关,并且肝活检显示NASH在肥胖的围青春期儿童中发病率较高,患者可无任何临床症状但肝脏损害却很明显[1]。因此,对肥胖儿童NAFLD的早期认识将对成人肝病的防治有重大的意义。1流行病学儿童肥胖症现已成为许多国家和地区严重的健康问题和社会问题。在英国,6岁和15岁儿童超重分别占22 %、31 % ,肥胖分别为10 %、17 % [2];在北美,无论是男性…     

非酒精性脂肪性肝病治疗药物的循证评价

目前非酒精性脂肪性肝病(NAFLD)治疗方法众多,疗效评价不一。本文结合临床研究从循证医学角度评述治疗NAFLD的方法和药物,以提高临床对NAFLD的治疗水平。     

减肥药用于非酒精性脂肪性肝病治疗的评价

非酒精性脂肪性肝病(NAFLD)是一种临床综合征,其肝组织学改变与酒精性肝病相类似但患者并无过量饮酒史.NAFLD患者通常合并肥胖症,而肥胖又可加重NAFLD的病情,甚至导致肝功能衰竭等终末期肝病.NAFLD患者肝细胞内过量脂肪沉积可能涉及多种机制,部分临床研究及动物试验显示,肥胖可致内脏脂肪组织功能失调、异常细胞因子表达及内源性大麻素系统相关的免疫紊乱等.近来研究提示,减轻体重有益于NAFLD的治疗.本文主要介绍并评价减肥药在NAFLD治疗中的作用,包括奥利司他、西布曲明及利莫那班等.     

天然免疫与非酒精性脂肪肝病

肝脏中大量的巨噬细胞、自然杀伤细胞(natural killer,NK)、自然杀伤T细胞(natural killer T cell,NKT)等构成了天然免疫系统.这一系统细胞功能紊乱,发生Th-1极化,使促炎症因子产生增多,促进了非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)的形成;肝脏持续的暴露于这些炎症因子,可以促进多种促纤维化因子产生,但Th-2细胞因子分泌的不足, 使NASH进一步发展为肝硬化的现象却相对比较少见.本文就肝脏天然免疫系统在非酒精性脂肪肝病(nonalcoholic fatty liver disease, NAFLD)中的调节机制作一综述.     

脂肪细胞因子与非酒精性脂肪肝病

非酒精性脂肪肝病是发病率仅次于病毒性肝炎的常见肝病,是隐原性肝硬化的主要危险因素之一。多种脂肪细胞因子参与了脂肪肝的病理过程。本文就脂联素、瘦素、抵抗素、内脏脂肪素、Apelin、肠凝集素、网膜素等7种脂肪细胞因子与非酒精性脂肪肝的关系研究进展作一综述。     

非酒精性脂肪性肝病的综合治疗

非酒精性脂肪性肝病(NAFLD)是代谢综合征在肝脏的表现,其疾病谱包括非酒精性单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)和肝硬化.其治疗应为综合性下预,包括通过调整生活方式、药物及手术治疗等方法改善胰岛素抵抗,减少易致肝脏损伤的因素,必要时可应用保肝抗炎药物,终末期NAFLD患者需行肝移植术.     

胰岛素增敏剂在非酒精性脂肪性肝病中的应用

近年我国非酒精性脂肪性肝病(NAFLD)的患病率逐渐增高,胰岛素抵抗在NAFLD发病机制中具有重要作用,胰岛素增敏剂如噻唑烷二酮类药物和二甲双胍等逐渐成为NAFLD治疗药物的研究重点.本文综述近年NAFLD的临床治疗研究,评价胰岛素增敏剂在NAFLD治疗中的作用.     

GI epidemiology: nonalcoholic fatty liver disease

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a common diagnosis in clinical practice. Insulin resistance and oxidative stress play an important role in NAFLD development and progression. AIM: To review the data available on the epidemiology and natural history of NAFLD as well as the risk factors for its development and the areas where future research is necessary. RESULTS /CONCLUSIONS: NAFLD may affect individuals of any age range and race/ethnicity. NAFLD affects one in three adults and one in ten children/adolescents in the United States. Mortality in patients with NAFLD is significantly higher than in the general population of same age and gender with liver-related complications being a common cause of death. Liver-related morbidity and mortality in NAFLD occurs when the disease has progressed to advanced fibrosis and cirrhosis. Further studies are necessary to determine the impact of NAFLD on health-related quality of life and resources utilization, and to the extent to which preventing the development of the metabolic syndrome would prevent NAFLD development and reduce liver-related morbidity and mortality. Lifestyle intervention may improve NAFLD, but medications that increase insulin sensitivity and the antioxidant defenses in the liver deserve evaluation in carefully controlled trials.     

Current therapies for nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in adults and children in many regions of the world. Although a relatively benign condition in some, for others the disease will progress to cirrhosis and end-stage liver disease with associated complications including hepatocellular cancer. Pharmaceutical therapies have had mixed results and none are accepted as standard therapy. Depending on the metric used to assess response (biochemical or histological), there are some therapies which may afford benefit. Others, however, have caused less than desirable adverse effects. Unfortunately, no particular treatment has emerged as safe and highly effective. The cornerstones of management of this problematic condition should include exercise and efforts at weight reduction through dietary changes and increased physical activity. Weight reduction does indeed seem to be beneficial in this setting, as evidenced by studies including those evaluating the effect of bariatric surgery. Less is known, however, about the effort of exercise in and of itself as a treatment strategy, even in the absence of a reduction in body weight. In this paper, we review the literature pertaining to the current state of NAFLD management with an emphasis on pharmacotherapy.