非酒精性脂肪性肝病的药物治疗

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD) 是世界范围内最普遍的慢性肝病，但目前尚无 治疗NAFLD 的特效药物。饮食及生活方式改变是NAFLD 的基础治疗，但药物治疗也必不可少，主要是针对代谢 综合征和肝脏损伤的药物。目前常用药物有保肝药、胰岛素增敏剂、调脂药物、抗氧化剂、减肥药和肠道益生菌制剂 等, 针对NAFLD 不同发病机制的各种新型靶向药物也相继进入临床试验。文章对近年来NAFLD 的药物治疗及研 究近况加以概述。     

甘草酸二铵脂质配位体治疗高脂饮食大鼠非酒精性脂肪性肝病疗效观察

非酒精性脂肪性肝病（NAFLD）的诊断和治疗是目前肝病研究的重点和热点之一,但由于其病因繁多且发病机制尚不十分明确,目前临床上尚无治疗此病的满意药物。甘草酸二铵脂质配位体已初步应用于临床辅助治疗多种慢性肝病,但关于其治疗MAFLD的研究报道少见,本研究通过建立高脂饮食大鼠NAFLD模型,观察甘草酸二铵脂质配位体对大鼠NAFLD的治疗效果。     

非酒精性脂肪性肝病的治疗进展

非酒精性脂肪性肝病(NAFLD)的病因和发病机制较复杂,迄今尚未完全明了,因此,目前临床上缺乏针对NAFLD治疗的有效药物。NAFLD的治疗,多数学者认为重点在于去除病因,治疗原发疾病;调整饮食,修正不良行为,合理运动,辅以一定的药物治疗。根据NAFLD发生的临床表现和异常的实验室结果酌情进行药物选择。本文就目前非酒精性脂肪性肝病的治疗进展作一简要概述。     

非酒精性脂肪性肝病的治疗进展

非酒精性脂肪性肝病(NAFLD)的病因和发病机制较复杂，迄今尚未完全明了，因此，目前临床上缺乏针对NAFLD治疗的有效药物。NAFLD的治疗，多数学认为重点在于去除病因，治疗原发疾病；调整饮食，修正不良行为，合理运动，辅以一定的药物治疗。根据NAFLD发生的临床表现和异常的实验室结果酌情进行药物选择。本就目前非酒精性脂肪性肝病的治疗进展作一简要概述。     

非酒精性脂肪性肝病的非药物治疗进展

非酒精性脂肪性肝病(NAFLD)为国内外最常见的肝病之一,其发病率逐渐上升,但药物治疗的疗效并不确切,近年NAFLD的非药物治疗逐渐受到重视。生活方式改变和减肥手术均可对NAFLD产生积极影响,红外肝病治疗仪亦能起一定作用。尽管NAFLD的治疗手段逐渐多样化,但目前尚缺乏更多的随机对照试验来证实其有效性。     

非酒精性脂肪性肝病的药物治疗进展

非酒精性脂肪性肝病(NAFLD)发病率逐年上升,正逐渐成为全球成人和儿童最常见的慢性肝病,其疾病谱中的非酒精性脂肪肝炎(NASH)可导致肝硬化和肝细胞癌。然而因NAFLD发病机制复杂,目前尚无有效的治疗药物。因此,NASH的新药研发是近年来研究的热点。本文总结了NASH发病机制重点阐明NASH潜在的治疗靶点及药物研究进展。     

跟踪非酒精性脂肪性肝病的临床试验-无创指标评价

非酒精性脂肪性肝病(NAFLD)已成为当前肝病领域的研究热点之一,但迄今为止,美国食品药品监督管理局尚未批准用于非酒精性脂肪性肝炎的治疗药物,NAFLD的临床治疗试验仍面临诸多机遇与挑战。肝脏组织学目前被认为是追踪NAFLD进展的可靠替代终点,但由于其有创性也制约了NAFLD治疗药物的开发。近年来,一些非侵入测量方法已被应用于当前临床试验的次要或探索性终点。     

非酒精性脂肪性肝病治疗进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是全世界最常见的慢性肝病,给社会带来严峻的经济负担。目前NAFLD的治疗包括生活方式干预、药物治疗、外科手术治疗。本文结合国内外文献对NAFLD的治疗进展进行概述。     

非酒精性脂肪性肝病的治疗策略

非酒精性脂肪性肝病（NAFLD）与胰岛素抵抗和遗传易感性关系密切。随着肥胖和糖尿病发病率增加,NAFLD已成为我国常见的慢性肝病之一。NAFLD尚无疗效理想的治疗药物,目前的治疗主要是纠正潜在的危险因素,针对性选择应用一些药物,阻止病情进展。NAFLD的治疗策略为：（1）鉴别和治疗相关的代谢紊乱,例如糖尿病和高脂血症;（2）通过减肥、锻炼、行为纠正和药物等纠正相关的代谢紊乱;（3）选择性地使用保肝药物如抗氧化剂等;（4）终末期肝病行肝移植。     

非酒精性脂肪性肝病在研新药的进展

非酒精性脂肪性肝病(NAFLD)是全世界最常见的肝脏疾病,与肥胖、胰岛素抵抗和其他代谢性疾病密切相关。目前尚无批准用于治疗的药物,常规的生活方式管理也难以对疾病产生积极的影响。对目前在研的代谢调节剂、抗炎抗氧化剂及抗纤维化剂等NAFLD治疗药物进行了综述,归纳总结了其临床研究结果,为NAFLD的临床治疗及药物研发提供新思路。     

非酒精性脂肪性肝病代谢组学研究进展

非酒精性脂肪性肝病(NAFLD)发病率逐渐升高,已成为我国第一大慢性肝病的首要原因。目前对NAFLD的发病机制并未完全阐明且无特效药物。从发病机制、无创诊断、药物作用与疗效角度出发,介绍了以机体内源性小分子代谢物为研究对象的代谢组学在NAFLD中的研究进展,为进一步探索NAFLD提供新的思路与方法。     

熊去氧胆酸在治疗非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病（NAFLD）是一种以肝细胞脂肪变性和脂质沉积为特征,但无过量饮酒史的临床综合征。NAFLD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）及其相关的肝纤维化和肝硬化。虽然NAFLD现已成为全球最常见的肝脏疾病之一,但目前仍无有效治疗手段和药物。现有研究提示熊去氧胆酸（UDCA）对NAFLD有一定治疗作用,本文就基于循证医学证据总结UDCA在NAFLD治疗方面的现状,并就UDCA的疗效作一评价和综述。     

Research progress on the mitochondrial mechanism of age-related non-alcoholic fatty liver

Non-alcoholic fatty liver disease(NAFLD) has become the most common chronic liver disease worldwide. Reduced activity and slower metabolism in the elderly affect the balance of lipid metabolism in the liver leading to the accumulation of lipids. This affects the mitochondrial respiratory chain and the efficiency of β-oxidation and induces the overproduction of reactive oxygen species. In addition,the dynamic balance of the mitochondria is disrupted during the ageing process,which inhibits its ph...     

非酒精性脂肪性肝病与抑郁症的关系

非酒精性脂肪性肝病(NAFLD)已成为世界上最常见的慢性肝病之一。随着生物-心理-社会医学模式的发展,NAFLD患者的精神健康问题逐渐受到重视。近年来,NAFLD与精神性疾病,特别是抑郁症的相关研究越来越多,且证实二者存在明显的相关性。但二者相关性的共同病理生理机制仍不明确,孰因孰果及治疗方式亟待进一步研究。综述了NAFLD与抑郁症的关系、共同病理生理机制及治疗的研究进展。期望为两者关系更深层次的研究打下基础,有助于未来临床对这两种疾病进行联合预防和治疗。     

Body weight loss and glycemic control on the outcomes of patients with NAFLD. The role of new antidiabetic agents

Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease worldwide affecting a third of adults and 12% of children in Western countries. In around 50–60%% of cases, NAFLD and type 2 diabetes mellitus (T2DM) coexist and act synergistically to increase the risk of adverse hepatic and extra-hepatic outcomes. T2DM is a strong risk factor for rapid progression of NAFLD to nonalcoholic steatohepatitis (NASH), cirrhosis or hepatocellular carcinoma (HCC), which have become frequent indications of liver transplantation.The pathophysiology of NAFLD is complex and its relationship with T2DM is bidirectional, where lipotoxicity and insulin resistance (IR), act as the strongest pillars.To date, no pharmacological treatment has been approved for NAFLD. However, there is an intense research with numerous drugs focused on reversing inflammation and liver fibrosis through modulation of molecular targets without good results.It has been known for some time that weight reduction >10% is associated to histological improvement of NAFLD. Recently, glycemic control has been shown to induce similar results. Diet and physical exercise for weight reduction have limitations, so alternative methods (pharmacologic, endoscopic or surgical) may be required. Currently, new antidiabetic drugs inducing weight loss, have been recently approved for the treatment of obesity. Nevertheless, their therapeutic effects on NAFLD have not been extensively studied.We will review here, recently published data on the effects of weight loss and glycemic control on the histological and metabolic parameters of NAFLD and recent published data on therapeutic studies of NAFLD with new antidiabetic drugs.     

非酒精性脂肪性肝病的药物治疗进展

非酒精性脂肪性肝病（NAFLD）主要表现为肝实质细胞脂肪变性和脂肪沉积,可在脂肪肝、肝炎基础上进展为肝纤维化和肝硬化,甚至出现肝衰竭或其他并发症。因此有必要在调整生活方式的同时加以药物干预。治疗NAFLD的药物大致分为三类：控制危险因素的药物、利胆保肝药和中药。本文主要就NAFLD的药物治疗作一概述。     

Current therapeutic strategies in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease ranging from simple steatosis through steatohepatitis (NASH) to increasing fibrosis and eventual cirrhosis. NAFLD is the hepatic manifestation of the metabolic syndrome and has now become the most common cause of liver disease in Western countries, with the more advanced stages of disease being associated with an increased risk of liver-related morbidity and mortality. The optimal management of patients with NAFLD remains a clinical challenge. The aim of this study is to describe established and emerging strategies for the treatment of NAFLD. Relevant research and review articles were identified by searching PubMed. Selected articles referenced in these publications were also examined. Good quality randomized controlled studies have demonstrated the need for multifaceted lifestyle interventions in patients with NAFLD including the need for diet, exercise and behavioural counselling. Despite several trials of pharmacological agents, no highly effective treatment yet exists, with surgery representing the mainstay for advanced disease. A multidisciplinary approach, with a major focus on lifestyle change, represents best treatment pending the development of new therapeutic options.     

omega-3多不饱和脂肪酸治疗非酒精性脂肪性肝病的研究进展

随着人们生活方式和饮食结构的改变,非酒精性脂肪性肝病(NAFLD)发病率逐年上升,严重威胁人类健康。NAFLD疗法一直是基础和临床肝病研究的热门领域。近年来,诸多研究揭示omega-3多不饱和脂肪酸(ω3-PUFA)可促进脂肪酸氧化并改善肠道稳态,从而改善脂代谢和肝脏炎症,因而越来越多的临床研究开始将ω3-PUFA运用于NAFLD的治疗中。然而,ω3-PUFA治疗NAFLD的机制尚不明确,相关临床研究也存在一定局限性。主要介绍了ω3-PUFA在NAFLD中发挥的作用以及相关的临床研究结果,并进一步讨论ω3-PUFA治疗NAFLD尚需解决的问题。     

非酒精性脂肪性肝病药物治疗进展

非酒精性脂肪性肝病（NAFLD）是我国肝酶异常和慢性肝病的常见原因之一,其治疗包括控制饮食、运动锻炼和药物治疗。目前,临床上治疗NAFLD的药物包括减肥药、胰岛素增敏剂、抗氧化剂、抑制肾素血管紧张素系统的降压药、调脂药、细胞因子调节剂和具有良好前景的大麻素受体拮抗剂。在此对NAFLD治疗药物的近期发展作一综述。     

肠道微生态失衡致非酒精性脂肪性肝病发病机制的研究进展

非酒精性脂肪性肝病（NAFLD）已成为一种常见的慢性肝病。近年肠道微生态失衡致NAFLD发病的机制研究已成为一个新的热点。国内外文献已报道相关发病机制可能包括干扰代谢、促进胰岛素抵抗、产生毒性代谢产物、增加肠壁通透性、激活肠道免疫、加重肝脏脂质氧化和氧化应激、激活肝脏免疫炎症损伤和肝纤维化等。而NAFLD发展到一定阶段后又可反过来影响肠道微生态,形成恶性循环。本文就肠道微生态失衡致NAFLD发病机制的研究进展作一综述。