肝硬化肌肉减少症的发病机制和诊疗的研究进展

Research progress of pathogenesis,diagnosis and treatment of sarcopenia in liver cirrhosis

目的了解肝硬化肌肉减少症的发病机制和诊疗的研究进展。方法查阅近年来有关肝硬化肌肉减少症的发病机制和诊疗研究的相关文献并进行综述。结果肌肉减少症已成为肝硬化患者不可忽视的并发症之一,与患者的生存质量及预后密切相关。代谢异常、营养不良、肌肉生长抑制素、高氨血症、激素调节肌肉稳态、泛素-蛋白酶体系统和自噬、体力活动、肠道菌群失调等多种机制参与了肌肉减少症的发生。肌肉减少症的诊断方法多种多样,但仍缺乏统一的金标准。此外,近年来在肌肉减少症的治疗方面也取得了一定的进展。结论目前研究对肝硬化和肌肉减少症的关系有了一定的认识,但仍有很多亟待解决的问题,未来更进一步的研究将使肝硬化肌肉减少症患者的诊疗获益。

Objective To summarize the research progress of the pathogenesis,diagnosis and treatment of sarcopenia in liver cirrhosis.Method The relevant literatures on studies of the pathogenesis,diagnosis and treatment of sarcopenia in liver cirrhosis in recent years were searched and reviewed.Results The sarcopenia was a major complication that could not be ignored in patients with liver cirrhosis,and was closely related to the patient’s quality of life and prognosis.Various mechanisms such as metabolic abnormalities,malnutrition,myostatin,hyperammonemia,hormonal regulation of muscle homeostasis,ubiquitin-proteasome system and autophagy,physical activity,and dysbiosis of the intestinal flora were involved in the development of sarcopenia.There were various diagnostic methods for sarcopenia,but a unified gold standard was still lacking.In addition,some progress had been made in the treatment of sarcopenia in recent years.Conclusions Although current studies obtains preliminary results about relation between liver cirrhosis and sarcopenia,there still exists many problems to be solved.Further research in future will benefit diagnosis and treatment of patients with sarcopenia in liver cirrhosis.