非酒精性脂肪性肝病肝脏微循环障碍探索

Liver microcirculation disturbance in nonalcoholic fatty liver disease

目前非酒精性脂肪性肝病发病机制尚不完全清楚,但肝脏微循环灌注改变是疾病进展的一个重要特征,其中肝细胞脂肪蓄积是导致微血管损伤的关键。介绍了正常微循环功能及结构、神经调节,着重分析了肝病微循环变化机制继而引发的微观细胞分子水平变化及宏观影像学改变。故推测,探明肝脏微循环变化可为非酒精性脂肪性肝病的病理生物学提供新见解,优化无创诊断帮助识别高危人群及早期非酒精性脂肪性肝炎患者。

At present,the pathogenesis of nonalcoholic fatty liver disease(NAFLD)is not completely clear,but hepatic microcirculation perfusion is an important feature of disease progression,in which lipid accumulation in hepatocytes is the key to microvascular injury.This article introduces the function,structure,and neuromodulation of normal microcirculation,with a focus on the mechanism of liver microcirculation disturbance and the changes in cellular molecules and imaging findings due to such disturbance.Therefore,clarification of liver microcirculation disturbance can provide new insights into the pathophysiology of NAFLD,and optimized noninvasive diagnostic methods may help to identify high-risk populations and patients in the early stage of nonalcoholic steatohepatitis.