代谢内镜对肥胖性肝病中的纤维化回归的影响
Leandro Sierra1, Arjun Chatterjee2, Renan Prado1
1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
World journal of hepatology
|September 30, 2025
概括
代谢内镜提供了一种微创的方法来管理代谢功能障碍相关的脂肪肝炎 (MASH) 中的肝纤维化. 内镜外套胃形成术 (ESG) 显示出最有前途的纤维化减轻.
科学领域:
- 胃肠病学和肝病学
- 代谢障碍 代谢障碍 代谢障碍
- 最少侵入性的手术
背景情况:
- 代谢功能障碍相关的脂肪性肝病 (MASLD),包括其渐进形式的MASH,影响全球超过三分之一的成年人.
- MASLD与肥胖,胰岛素抵抗和代谢综合征有关,需要新的治疗方法.
- 目前的治疗方法,如改变生活方式和减肥手术,面临着坚持和可访问性的挑战.
研究的目的:
- 在MASH中审查用于管理肝纤维化的内镜腹性代谢疗法.
- 评估各种内镜手术在逆转肝纤维化的安全性和有效性.
主要方法:
- 对代谢内镜的临床研究和元分析的审查.
- 检查包括ESG,IGB,DMR,DJBL,ERG和TORe在内的程序.
主要成果:
- 代谢内镜对于MASH相关的肝纤维化是安全有效的.
- 内镜套管胃形成术 (ESG) 证明了最显著的纤维化减少.
- 胃内气球 (IGB) 和双胞胎节绕道线 (DJBL) 显示了适度的改善.
- 十二指甲膜粘膜复苏 (DMR) 对纤维化没有显著影响.
- 内镜修复性胃形成术 (ERG) 显示纤维化减少;TORe需要进一步评估.
结论:
- 代谢内镜为MASH管理提供了一个可行的,最少侵入性的选择.
- ESG是减少肝纤维化的领先内镜疗法.
- 需要进一步的研究,以充分评估像TORe.这样的修订性内镜手术.
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