慢性肝病女性患者绝经后雌激素抗肝纤维化的作用机制

Mechanism of estrogen against liver fibrosis in postmenopausal women with chronic liver disease

女性绝经后机体代谢水平紊乱,患有慢性肝病的女性进展为肝纤维化的风险增加,且风险高于同龄男性患者。这可能与女性绝经后卵巢功能衰退、体内雌激素水平下降有关。主要从雌激素与氧化应激、肝星状细胞的活化、细胞外基质的堆积、免疫调节的关系等方面归纳了患有慢性肝病的女性患者进展为肝纤维化的分子机制研究进展。从而提出给予围绝经期和绝经初期女性患者补充适量的雌激素可以降低肝纤维化的风险,延缓甚至逆转肝纤维化的进程,从而改善老年女性患者的生存质量、延长生存时间。

Metabolic disorders are observed in women after menopause,and the postmenopausal women suffering from chronic liver diseases have an increased risk of progression to liver fibrosis,with a higher risk than male patients of the same age,which may be associated with the decline of ovarian function and the reduction of estrogen level after menopause.This article summarizes the research advances in the molecular mechanism of progression to liver fibrosis from the aspects of estrogen and oxidative stress,activation of hepatic stellate cells,accumulation of extracellular matrix,and immune regulation.It is pointed out supplementation with an appropriate amount of estrogen in the perimenopausal period and the early menopausal period can reduce the risk of liver fibrosis and delay or even reverse the process of liver fibrosis,thereby improving quality of life and prolonging survival time in elderly female patients.