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胃内镜重塑及其对代谢功能障碍相关脂肪肝炎的组织学影响:为期12个月的前性研究

Pichamol Jirapinyo¹, David J Papke², Guadalupe Garcia-Tsao³

¹Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

Gastrointestinal endoscopy

|March 5, 2026

概括

内镜胃改造 (EGR) 为代谢功能障碍相关的脂肪肝炎 (MASH) 提供了一个有希望的一次性治疗方法. 这种微创手术显著改善了MASH,纤维化和患者的体重减轻.

科学领域:

肝病学肝病学是一种肝病学.
胃肠病学胃肠病学
腹腔内镜检查腹腔内镜检查腹腔内镜检查

背景情况:

代谢功能障碍相关的脂肪肝炎 (MASH) 是一个日益严重的健康问题,目前的第一线治疗方法,如生活方式改变和GLP-1受体激动剂 (GLP-1RAs) 有局限性.
生活方式的修改往往导致体重减轻不足,而长期使用GLP-1RA在患者的采用和坚持方面面临挑战.
需要有效,可持续的干预措施来管理MASH及其相关纤维化.

研究的目的:

评估内镜胃改造 (EGR) 作为一次性,最少侵入性干预措施的疗效,以改善MASH的组织学特征.
评估EGR对减肥的影响,MASH分辨率,肝纤维化和非酒精性脂肪肝疾病 (NAFLD) 活动评分 (NAS).

主要方法:

一项为期12个月的前性研究,涉及20名肥胖患者和经过活检证明的有纤维化的MASH患者.
受试者使用FDA批准的内镜复合装置进行EGR.
评估包括EUS引导的肝脏活检和基线和随访时的移植系统压力梯度测量.

主要成果:

13名受试者完成了12个月的随访,实现了平均16.5%的体重减轻.
73%的受试者实现了≥10%的总体重减轻,MASH解脱率为46%,纤维化改善率为54%.
在NAS (85%) 和端口系统压力梯度 (PPG) 中观察到显著改善,没有严重的不良事件.

结论:

胃内镜改造 (EGR) 显示出作为MASH的最小侵入性治疗的巨大潜力.
EGR有效地改善MASH的关键组织学特征,包括肝硬化症,炎症,气球膨胀和纤维化.
这种一次性干预为MASH患者提供了一个有希望的替代方案,他们希望获得实质性和持续的好处.

关键词:

在EBMTs中,EBMTs可以使用.欧洲农业集团 (EGR) 的成员.这是ESG ESG.马什 (MASH) 是一个非常重要的产品.马斯尔德马斯尔德是什么意思这是一个NIT.摆姿势 (POSE) 是一种姿势.肝脏纤维化肝脏纤维化肝脏肥胖症肝脏肥胖症肝脏活检活检肝脏活检非侵入性试验试验是非侵入性试验.

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