儿童非酒精性脂肪性肝病研究进展

Study advances of nonalcoholic fatty liver disease in children

肥胖儿童非酒精性脂肪性肝病（NAFLD）日益成为儿童及青少年慢性肝脏疾病最常见的原因之一，其中包括单纯性脂肪肝和脂肪性肝炎，以及由其演变的肝硬化和肝细胞癌，被认为是代谢综合征在肝脏的表现。关于NAFLD的发病机制目前较为流行的是“多次打击”学说。临床表现、实验室及影像学检查均有助于NAFLD的诊断，但肝穿刺活检被认为是诊断的金标准，且对于评价肝脏炎症及纤维化程度尤为重要。虽然有关NAFLD的药物治疗已经进入临床试验阶段，但饮食、运动等基础治疗仍起着至关重要的作用。

Nonalcoholic fatty liver disease（NAFLD） in obese children has increasingly become the most com- mon cause of chronic liver disease in children and adolescents. NAFLD includes simple steatosis and nonalcoholic steatohepatitis, which will progress to cirrhosis and hepatocellular carcinoma. It is recognized as a hepatic manifestation of metabolic syndrome. With regarding to the pathogenesis of NAFLD, the ＂multiple-hit＂ hypothesis is more popular. Although clinical symptoms, laboratory data, and imaging findings are important, liver biopsy is regarded as the gold standard for the diagnosis of NAFLD. In addition,liver biopsy is essential for assessing the degree of necro-inflammatory change and fibrosis in NAFLD. Although pharmacotherapy has been studied in clinical trials, lifestyle modification by diet and exercise remains the mainstay of treatment for NAFLD.