肝硬化患者代谢特征及营养素与肝再生的关系

Metabolic characteristics of cirrhotic patients and the relationship between nutrients and liver regeneration

肝硬化患者疾病进展及并发症与营养状态密切相关,营养不良在肝硬化患者中的发病率相对较高,合并肌少症者预后更加不良,其代谢特征表现为营养物质摄入、吸收和合成代谢受阻,以及与肠道损耗增加和促炎细胞因子水平升高相关的高代谢消耗状态。临床早期识别不良代谢状态和及时干预对肝硬化患者疾病进展至关重要,包括葡萄糖、氨基酸和脂肪在内的营养素可能通过影响肝再生过程对肝硬化病程发生影响,相关机制复杂且值得进一步研究。通过营养素补充的干预方式,调控残存正常肝脏组织的再生能力,是否能够减缓甚或逆转肝硬化进程,提高生存率,是以后基础与临床研究的重要方向。本文就肝硬化患者的代谢特征及营养素与肝再生的关系做一评述,以供临床研究参考与借鉴。

The disease progression and complications of liver cirrhosis patients are closely related to nutritional status.The inci-dence rate of malnutrition in liver cirrhosis patients is relatively high,and the prognosis of patients with sarcopenia is even worse.Its metabolic characteristics are the impairment of nutrient intake,absorption and anabolism,and the high metabolic consumption state as-sociated with increased intestinal loss and increased levels of proinflammatory cytokines.Early clinical identification of adverse meta-bolic states and timely intervention are crucial for the progression of liver cirrhosis in patients.Nutrients,including glucose,amino ac-ids,and fat,may have an impact on the course of liver cirrhosis by influencing the process of liver regeneration,and the related mecha-nisms are complex and worthy of further research.Whether regulating the regenerative ability of residual normal liver tissue through nu-trient supplementation intervention can slow down or even reverse the progression of liver cirrhosis and improve survival rate is an im-portant direction for future basic and clinical research.This article provided a review of the metabolic characteristics of patients with liver cirrhosis and the relationship between nutrients and liver regeneration,aiming to serve as a reference for clinical research.