医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2015年
8期
1406-1409
,共4页
黄婷婷%周玉荣%张向君%刘沙沙(综述)%殷晶晶%王加林(审校)
黃婷婷%週玉榮%張嚮君%劉沙沙(綜述)%慇晶晶%王加林(審校)
황정정%주옥영%장향군%류사사(종술)%은정정%왕가림(심교)
非酒精性脂肪肝%胰高糖素样肽1%减重手术
非酒精性脂肪肝%胰高糖素樣肽1%減重手術
비주정성지방간%이고당소양태1%감중수술
Nonalcoholic fatty liver disease%Glucagon-like peptide 1%Bariatric surgery
非酒精性脂肪肝( NAFLD)是西方国家最常见肝病,在我国的发病率日益上升,且呈低龄化趋势。胰岛素抵抗在NAFLD的发生发展中起关键作用。目前暂无批准治疗 NAFLD的药物,但许多治疗方法是有益的。生活方式改变仍是治疗NAFLD 的基础。体质量减轻可改善肝脂肪变性,且体质量减轻10%甚至可以改善脂肪肝炎。此外,常用的胰岛素增敏剂、抗氧化剂和调脂抗炎药物同样是治疗NAFLD比较有前景的药物。肠促胰岛素疗法有可能改善肥胖和糖尿病的肝脂肪变性。由此研发的新型糖尿病治疗药物胰高血糖素样肽1类似物相对于NAFLD传统治疗手段表现出了更广阔的潜在价值。同时,减重手术的不断发展,对治疗NAFLD合并病态肥胖患者具有独特的临床意义。
非酒精性脂肪肝( NAFLD)是西方國傢最常見肝病,在我國的髮病率日益上升,且呈低齡化趨勢。胰島素牴抗在NAFLD的髮生髮展中起關鍵作用。目前暫無批準治療 NAFLD的藥物,但許多治療方法是有益的。生活方式改變仍是治療NAFLD 的基礎。體質量減輕可改善肝脂肪變性,且體質量減輕10%甚至可以改善脂肪肝炎。此外,常用的胰島素增敏劑、抗氧化劑和調脂抗炎藥物同樣是治療NAFLD比較有前景的藥物。腸促胰島素療法有可能改善肥胖和糖尿病的肝脂肪變性。由此研髮的新型糖尿病治療藥物胰高血糖素樣肽1類似物相對于NAFLD傳統治療手段錶現齣瞭更廣闊的潛在價值。同時,減重手術的不斷髮展,對治療NAFLD閤併病態肥胖患者具有獨特的臨床意義。
비주정성지방간( NAFLD)시서방국가최상견간병,재아국적발병솔일익상승,차정저령화추세。이도소저항재NAFLD적발생발전중기관건작용。목전잠무비준치료 NAFLD적약물,단허다치료방법시유익적。생활방식개변잉시치료NAFLD 적기출。체질량감경가개선간지방변성,차체질량감경10%심지가이개선지방간염。차외,상용적이도소증민제、항양화제화조지항염약물동양시치료NAFLD비교유전경적약물。장촉이도소요법유가능개선비반화당뇨병적간지방변성。유차연발적신형당뇨병치료약물이고혈당소양태1유사물상대우NAFLD전통치료수단표현출료경엄활적잠재개치。동시,감중수술적불단발전,대치료NAFLD합병병태비반환자구유독특적림상의의。
Nonalcoholic fatty liver disease(NAFLD) is the most common liver disease in western world. Its incidence is increasing rapidly in China and is showing a trend in younger ages .Insulin resistance is believed to play a crucial role in the pathogenesis of NAFLD .Despite that there is currently no approved drug therapy for NAFLD, many approaches appear to be beneficial.Life style changes remains the cornerstone of treatment for NAFLD.Weight loss can improve hepatic steatosis,and 10% of weight loss may even improve fatty hepatitis.In addition,insulin sensitizers,antioxidants,lipid regulating and anti-inflammatory agents also show promising effects.The new preclinical tests show that the therapy based on incretin may improve the obesity,diabetes,and fatty degeneration of liver.Glucagan-Like peptide 1 analogues developed to treat diabe-tes show potential value in the treatment for NAFLD compared with the traditional treatment .At the same time,the continuous development of bariatric operation displays unique clinical significance in treating patients with NAFLD complicated by morbidly obese .