肝移植后代谢综合征及其防治的研究进展

Research progress on metabolic syndrome and its prevention and treatment after liver transplantation

肝移植(LT)被认为是终末期肝病、重型肝炎和晚期肝脏恶性肿瘤患者的唯一根治性选择。由于近几十年来围手术期护理、感染控制和免疫抑制药物的改善,肝移植受体的早期存活率取得了巨大进步,但移植后晚期(移植后5年以上)的存活率却没有提高,主要原因是恶性肿瘤和心血管并发症。代谢综合征(MS)即肥胖、高血压、血脂异常和高血糖,在移植受者中被诊断为肝移植术后代谢综合征(LTMS),影响肝移植受者长期生存。代谢综合征的许多方面都是可以改变的。这篇综述目的是总结目前关于LTMS及其相关组分的知识并探讨其防治与管理策略,旨在提供实用的循序渐进指导。

Liver transplantation(LT)is considered to be the only radical option for patients with endstage liver disease,severe hepatitis and advanced liver malignant tumor(primary).Due to the improvement of perioperative nursing,infection control and immunosuppressive drugs in recent decades,the early survival rate of liver transplant recipients has made great progress,but the survival rate in the late stage after transplantation(more than 5 years after transplantation)has not improved.The main causes of late death are malignant tumors and cardiovascular complications.Metabolic syndrome,defined as obesity,hypertension,dyslipidemia and hyperglycemia,is diagnosed as LTMS(liver transplantation metabolic syndrome)after liver transplantation in transplant recipients,affecting long-term survival.Many aspects of metabolic syndrome can be changed.The purpose of this review is to summarize the current knowledge about LTMS and its related components and to explore its prevention and management strategies,in order to provide practical step-by-step guidance.