儿童非酒精性脂肪性肝病的诊治进展

Diagnosis and treatment of non-alcoholic fatty liver disease in children

儿童非酒精性脂肪性肝病是年龄在18周岁以下的儿童及青少年肝脏慢性脂肪变性,其发病与胰岛素抵抗和遗传易感性密切相关。其临床症状常不具有特异性,诊断主要依赖于影像学表现及实验室检查,肝脏组织病理学检查为诊断"金标准",但因其创伤性不作为常规手段。儿童非酒精性脂肪性肝病需要注意与可引起肝脏脂肪变性的其他遗传代谢病及肝病相鉴别。目前饮食及运动疗法为其一线治疗方案,此外,保肝治疗、改善胰岛素抵抗、改善高脂血症、维生素E、益生菌的治疗作用也逐渐受到关注。

Non-alcoholic fatty liver disease(NAFLD)is a chronic steatosis of the liver in children and adolescents under 18 years of age.It is closely related to insulin resistance and genetic susceptibility.Its clinical symptoms are often non-specific.Diagnosis mainly depends on imaging findings and laboratory tests.Liver biopsy is the"golden standard",but it is not a routine approach because of its traumatic nature.NAFLD in children should be distinguished from other hereditary metabolic diseases and liver diseases that can cause liver steatosis.At present,diet and exercise therapy are its first-line treatment.In addition,hepatoprotective therapy,improvement of insulin resistance and hyperlipidemia,vitamin E,probiotics are also gradually attracting attention.