非酒精性胆固醇肝炎:一个审查
Adam C Sheka1, Oyedele Adeyi2, Julie Thompson3
1Department of Surgery, University of Minnesota, Minneapolis.
JAMA
|March 25, 2020
概括
无酒精性脂肪肝 (NASH) 是一个未被认可的肝脏疾病, 早期识别和改变生活方式,包括减肥,对于治疗NASH和预防肝硬化和移植等严重后果至关重要.
科学领域:
- 肝病学
- 内部医学
- 公共卫生
背景情况:
- 非酒精性脂肪性肝炎 (NASH) 是非酒精性脂肪性肝病 (NAFLD) 的炎症形式,通常会发展为肝硬化和肝移植.
- 美国3-6%的人口患有NASH,其患病率与肥胖,血脂不良,2型糖尿病和代谢综合征有关.
- 尽管NASH具有临床意义,但仍未得到充分的认可,肝脏活检是唯一的诊断标准.
研究的目的:
- 突出NASH的流行和临床意义.
- 强调早期识别和针对性管理NASH的必要性.
- 强调改变生活方式和减肥手术在治疗NASH和相关代谢疾病方面的重要性.
主要方法:
- 对NASH患病率和风险因素的当前流行病学数据的审查.
- 诊断挑战和局限性的分析,包括肝脏活检的作用.
- 检查当前的治疗模式,重点关注生活方式的改变和手术.
主要成果:
- 在美国,NASH影响3-6%的人口,患病率正在上升.
- 肥胖,脂质不良,2型糖尿病和代谢综合征是关键的相关疾病.
- 大约20%的NASH患者患有肝硬化,死亡率显著上升.
结论:
- 早期识别和针对性治疗NASH对于改善患者的结果至关重要.
- 主要治疗方法是强化改变生活方式以减肥.
- 在NASH患者的肥胖和代谢疾病治疗中,可能会使用腹腔外科手术.
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