非酒精性脂肪性肝病发病机制的研究进展

Research progress of the pathogenesis of non-alcoholic fatty liver disease

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种无过量饮酒史,组织学改变与酒精性肝病相类似的临床病理综合征。其病程包括单纯性脂肪肝、脂肪性肝炎(non-alcoholic steatohepatitis,NASH)和脂肪性肝纤维化,最后可能演变成肝硬化和肝癌。其病因与发病机制复杂,尚未完全明了,目前仍以"二次打击"学说为基础,但近年来研究表明肠肝轴、幽门螺杆菌感染、自噬与凋亡、脂肪因子、遗传变异、个人因素等均参与NAFLD的发生发展。本文就上述发病机制的研究进展作一系统回顾。

Non-alcoholic fatty liver disease （NAFLD） is a clinical syndrome which is similar to alcoholic liver dis- ease in histological changes but no heavy drinking history. The courses, including simple fatty liver, steatohepatitis and fatty liver fibrosis, may end up with turning into liver cirrhosis and liver cancer. The etiology and pathogenesis which are still based on the theory of ＂two hit＂, are complex and have not yet been fully understood. However, recent researches show that enterohepatic axis, Helicobacter pylori infection, autophagy and apoptosis, fat factor, genetic variation, per- sonal factors are also involved in the occurrence and development of NAFLD. In this paper, the research progress of pathogenesis mentioned above in recent years will be systematically reviewed.