代谢相关脂肪性肝病的治疗进展

Progress in the Treatment of Metabolism-Related Fatty Liver Disease

代谢相关脂肪性肝病(MAFLD)的发病率逐年增加,成为目前全球最常见的慢性肝脏疾病。本文总结了国内外最新指南及研究,旨在探讨当前MAFLD的治疗进展,主要涉及生活方式管理、药物治疗、减重手术、肝移植等多学科的治疗,其原则包括:一是针对肥胖和代谢性疾病进行的生活方式管理,二是针对不同代谢疾病和病理类型进行的个体化药物治疗和外科手术等。前者包含调整饮食结构、减轻体重、适量运动以及对血压、血脂、血糖异常等指标进行控制;后者包括二甲双胍、维生素C和E、利拉鲁肽、吡格列酮、他汀类药物及减重手术、肝移植等。但对于MAFLD患者来说,无论伴或不伴有肥胖,保持健康饮食和运动仍然是防治的根本。

The incidence of metabolism-related fatty liver disease (MAFLD) is increasing year by year and has become the most common chronic liver disease in the world. This paper summarizes the latest guidelines and research at home and abroad, explores the current MAFLD treatment progress, mainly involving lifestyle management, drug therapy, weight-loss surgery, liver transplantation, such as multi-disciplinary collaboration, the therapeutic principles include: one is to control man-agement for obesity and metabolic disease, the second is according to different pathological types of individualized drug therapy and surgery, etc. The former includes adjustment of diet, weight loss, moderate exercise and control of blood pressure, blood lipid, blood sugar and other indicators. The latter include metformin, vitamins C and E, liraglutide, pioglitazone, statins, bariatric surgery, liver transplantation, etc. However, for patients with MAFLD, maintaining a healthy diet and exercise are still essential for prevention and treatment, with or without obesity.