非酒精性脂肪性肝病的治疗进展

Update on the treatments of non-alcoholic fatty liver disease

目前全球非酒精性脂肪性肝病的发病率增加,并与代谢综合征,尤其是肥胖及糖尿病密切相关。越来越多的证据表明,胰岛素抵抗是代谢综合征患者发生脂肪性肝炎的关键病因,其可增加脂肪变性及肝脏游离脂肪酸聚集,刺激氧化应激反应,促进脂质过氧化及炎症细胞因子产生。非酒精性脂肪性肝病的治疗以改善代谢综合征为主,尚缺乏已验证的疗效理想的治疗药物。近年来随着对其发病机制的深入理解,一些尚处于动物试验及前期临床研究的新药值得关注。

Non-alcoholic fatty liver disease （NAFLD） is now the commonest liver disorder in the world. It is closely associated with the features of metabolic syndrome, particularly obesity and diabetes. More and more evidence show that insulin resistance is the key etiological factor of non-alcoholic steatohepatitis （NASH） occured in patients with metabolic syndrome. Indeed, insulin resistance can increase steatosis and subsequent accumulation of free fatty acids in liver, it can also stimulate the reaction of oxidative stress and promote lipid peroxidation as well as generation of inflammatory cytokine. Since there is no firm evidence-based medicine treatment for NAFLD, the therapy of which is currently direct- ing at improving metabolic syndrome. A variety of novel drugs which in periods of animal tests and prophased clinical studies are worthy of paying attention to following the elucidation of mechanisms leading to NAFLD recently.