减肥药用于非酒精性脂肪性肝病治疗的评价

Anti-obese drugs in the treatment of nonalcoholic fatty liver disease

非酒精性脂肪性肝病(NAFLD)是一种临床综合征,其肝组织学改变与酒精性肝病相类似但患者并无过量饮酒史。NAFLD患者通常合并肥胖症,而肥胖又可加重NAFLD的病情,甚至导致肝功能衰竭等终末期肝病。NAFLD患者肝细胞内过量脂肪沉积可能涉及多种机制,部分临床研究及动物试验显示,肥胖可致内脏脂肪组织功能失调、异常细胞因子表达及内源性大麻素系统相关的免疫紊乱等。近来研究提示,减轻体重有益于NAFLD的治疗。本文主要介绍并评价减肥药在NAFLD治疗中的作用,包括奥利司他、西布曲明及利莫那班等。

Nonalcoholic fatty liver disease （NAFLD） is a syndrome of which the hepatic histology resembles alcohol-induced liver injury, but occurs in patients with no history of alcohol abuse. NAFLD patients usually complicate obesity, and obesity is associated with the aggravation of NAFLD that may progress to end-stage liver disease. There are several mechanisms by which excess lipidosis accumulate in hepatocytes. Some animal models and clinical researches indicate that obesity can result in visceral adipose tissue dysfunction, aberrant cytokine expression and immunologic derangement related to endocannabinoid system. Recent researches indicate that weight loss could be beneficial for NAFLD treatment. This review summarizes the application of anti-obese drugs in the treatment of nonalcoholic fatty liver disease which include orlistat, sibutramine, rimonabant and so on.