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非酒精性脂肪性肝炎的病因、发病机制和治疗
Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis


Anna M. Diehl ... 其他 • 2017.11.23
相关阅读
• 吸烟对非酒精性脂肪肝的影响 • 非酒精性脂肪性肝炎的新疗法

中国与全球在非酒精性脂肪性肝炎的病因发病机制以及治疗方面的对比

 

杨蕊旭,范建高*

上海交通大学医学院附属新华医院消化内科

*通讯作者

 

非酒精性脂肪肝病(NAFLD)目前已经成为全球最常见的慢性肝病,而作为NAFLD疾病谱中的严重类型,非酒精性脂肪性肝炎(NASH)与肝纤维化的进展以及并发症的发生密切相关。在2017年11月23日出版的《新英格兰医学杂志》(NEJM)上,美国杜克大学Diehl教授和英国纽卡斯尔大学Day教授对NASH的流行病学、发病机制以及评估进行了讨论以及综述1

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脂肪肝病是全球最常见的肝病。美国约有25%的成人在非过量饮酒的情况下患脂肪肝,这种情况称为非酒精性脂肪肝病。在无其他明确肝损伤原因的基础上,基于血清转氨酶升高这一标志,患有非酒精性脂肪肝病的成人中超过1/4推断为非酒精性脂肪性肝炎1。确诊非酒精性脂肪性肝炎目前基于组织学观察到肝细胞中脂肪积聚(脂肪变性),以及肝细胞损伤、死亡和炎症细胞聚集(图1A和图1B)。由于非酒精性脂肪性肝炎的肝损害比单纯性肝脂肪变性更严重,因此非酒精性脂肪性肝炎与单纯性肝脂肪变性相比更易引起进行性肝纤维化,并最终引起肝脏相关疾病和死亡2-6(图1C)。本文主要综述了目前对非酒精性脂肪性肝炎流行病学和发病机制的理解,为这种危及生命的肝病的临床实践指南和药物开发提供支持。





作者信息

Anna M. Diehl, M.D., and Christopher Day, M.D.
From the Department of Medicine, Duke University, Durham, NC (A.M.D); and Newcastle University Medical School, Newcastle upon Tyne, United Kingdom (C.D.). Address reprint requests to Dr. Diehl at the Snyderman Bldg., Suite 1073, Duke University, Durham, NC 27710, or at annamae.diehl@duke.edu.

 

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