非酒精性脂肪性肝病的发病机制

引起机体脂类代谢失调诱发肝细胞脂肪变的因素很多,主要有两型。第一型是由于从血液中进入肝内的游离脂肪酸(FFA)增多,或脂肪酸氧化减少,肝细胞合成甘油三酯(TG)增多,极低密度脂蛋白(VLDL)的形成跟不上TG合成的速度,导致细胞内脂肪蓄积;第二型是由于载脂蛋白合成和分泌障碍,TG释放入血减缓,引起脂肪在肝内大量蓄积而导致脂肪肝。继而氧应激和异常细胞因子等的作用导致肝脏的坏死性炎症和纤维化。一、肝脏的脂类代谢异常1.FFA输送入肝脏过多:FFA输送入肝增多,可来自饮食、高脂血症及脂肪组织动员增加。首先是饮食中摄入过多脂肪,长期…     

非酒精性脂肪性肝病的发病机制

引起机体脂类代谢失调诱发肝细胞脂肪变的因素很多，主要有两型。第一型是由于从血液中进入肝内的游离脂肪酸（FFA）增多，或脂肪酸氧化减少，肝细胞合成甘油三酯（TG）增多，极低密度脂蛋白（VLDL）的形成跟不上TG合成的速度，导致细胞内脂肪蓄积；第二型是由于载脂蛋白合成和分泌障碍，TG释放入血减缓，引起脂肪在肝内大量蓄积而导致脂肪肝。继而氧应激和异常细胞因子等的作用导致肝脏的坏死性炎症和纤维化。     

非酒精性脂肪性肝病进展——非酒精性脂肪性肝病的流行率

脂肪肝是一种病变主体在肝小叶，以肝细胞弥漫性脂肪变为主的临床病理综合征。根据起病方式及病程，脂肪肝有急性与慢性之分，前者多为小泡性脂肪肝，后者则为大泡性或以大泡为主的混合性脂肪肝。通常所述的脂肪肝主要指慢性脂肪肝，包括单纯性脂肪肝、脂肪性肝炎和肝硬化三种病理类型，临床上则分为酒精性肝病和非酒精性脂肪性肝病（NAFLD）两大类。     

非酒精性脂肪性肝病治疗进展

随着人们生活方式的改变,饮食结构的变更,肥胖人群快速递增,非酒精性脂肪性肝病(NAFLD)发病率日益增长,因此NAFLD逐渐走进了人们的视线,成为研究的热点.NAFLD是指除外酒精和其他明确的肝损害因素所致的,以弥漫性肝细胞大泡性脂肪变为主要特征的临床病理综合征.随着对NAFLD研究的深入,认为NAFLD不再是良性病变,其疾病谱包括单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)、肝硬化和肝癌,是临床常见的慢性肝病.     

非酒精性脂肪性肝病的治疗进展

一、病因及合并症的治疗非酒精性脂肪性肝病(NAFLD)是一种多病因引起的获得性疾病,目前尚缺乏特效的治疗药物,故尽量明确其病因(如其他药物的毒副作用、慢性中毒、胃肠外营养、营养不良、重症贫血、慢性缺氧状态等)并及时给予相应的处理至关重要。NAFLD常合并糖尿病、代谢综合征等,并可互为因果,故应积极治疗合并疾病。二、饮食治疗和运动治疗调整饮食是NAFLD最基本的治疗方法,对于肥胖者或有代谢综合征者应控制饮食的总热量摄入,尤其是非饱和脂肪酸摄入及适当运动以减轻体重。有报道认为体重减轻5%即可检测到肝脏酶学的好转及肝组织…     

非酒精性脂肪性肝病的诊治进展

非酒精性脂肪性肝病(NAFLD)是一种严重威胁公众健康的代谢性疾病,有关其发病机制、诊断和治疗等方面的研究众多,但尚有争论。目前针对该病的多种具有新的作用机制的药物正在研发中,希望有越来越多的学者将注意力转向有前景药物的开发及其相关的临床试验研究中。本文综述了NALFD的发病机制、诊断和迄今为止的一些治疗策略,旨在帮助临床医生提高NAFLD的防治能力,更好地为NAFLD患者服务。     

非酒精性脂肪性肝病的治疗进展

一、病因及合并症的治疗 非酒精性脂肪性肝病（NAFLD）是一种多病因引起的获得性疾病，目前尚缺乏特效的治疗药物，故尽量明确其病因（如其他药物的毒副作用、慢性中毒、胃肠外营养、营养不良、重症贫血、慢性缺氧状态等）并及时给予相应的处理至关重要。NAFLD常合并糖尿病、代谢练合征等，并可互为因果，故应积极治疗合并疾病。     

非酒精性脂肪性肝病

正肝脏是人体内参与糖、蛋白和脂类代谢的重要器官,其中代谢的任何一个环节出现问题,均可引起脂肪在肝细胞堆积,而导致肝脏受损。非酒精性脂肪性肝病的发病正是基于这一过程。非酒精性脂肪性肝病又称非酒精性脂肪肝,是以脂肪在肝脏内沉积超过肝脏重量的5%～10%,弥     

非酒精性脂肪性肝病中线粒体损伤机制

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)是一种与胰岛素抵抗和遗传易感密切相关的代谢应激性肝损伤,其危害不仅仅局限于肝脏,还显著增加心脑血管疾病的发病风险。近年来,NAFLD在全球范围内呈流行趋势,已成为重大公共卫生问题。线粒体损伤机制如线粒体动力学、线粒体生物合成、脂肪酸β氧化及线粒体呼吸链在NAFLD发生发展中的作用越来越受到关注。     

非酒精性脂肪性肝病研究进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种无过量酒精摄入史,病变主体在肝小叶,以肝细胞弥漫性脂肪变性和脂肪贮积为主的临床病理综合征,持续进展则会出现严重肝损害,是我国愈来愈重视的慢性肝病问题。本文对NAFLD近年的研究新进展进行总结,主要包括流行病学、危险因素、发病机制、临床表现、诊断标准和治疗,以期为下一步研究和临床合理治疗提供依据。     

Nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) refers to the presence of hepatic steatosis not associated with a significant intake of ethanol. Insulin resistance is central to the pathogenesis of NAFLD; thus obesity, diabetes, and the metabolic syndrome are frequently associated with the disease. Consequently, as these metabolic conditions emerge as major health problems in Western society, it is now recognized that NAFLD is the most common chronic liver condition in the Western world. NAFLD is generally asymptomatic, although a minority of patients may present with evidence of progressive liver injury with complications of cirrhosis, liver failure, and hepatocellular carcinoma. Despite being common and potentially serious, relatively little is known about the natural history or prognostic significance of NAFLD. Although diabetes, obesity, and age are recognized risk factors for advanced liver disease, other significant factors leading to progressive liver injury remain to be identified. The treatment of NAFLD focuses upon modifying metabolic risk factors. Insulin-sensitizing and hepatoprotective drugs have been subjected to study trials, but as yet, no agent has conclusively been demonstrated to prevent disease progression. Management is further complicated by the inability to predict which patients will develop liver-related morbidity and thus benefit from treatment.     

Nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of disorders that encompasses simple hepatic steatosis and the more serious nonalcoholic steatohepatitis (NASH) that can progress to cirrhosis. Although the prevalence of NAFLD in childhood is not clear, it is apparently more common than originally thought. The major association with NAFLD is obesity, and as the prevalence of obesity in childhood and adolescence increases, fatty liver is recognized with greater frequency. Although the factors associated with progression of liver disease have not been determined fully, the pathogenesis of NASH is a "two hit" process that includes disturbed lipid homeostasis, resistance to the effects of insulin and subsequent hyperinsulinemia, and local toxic effects of triglyceride on hepatocytes. Treatment options are currently limited.     

Nonalcoholic fatty liver disease: pathogenesis and the role of antioxidants

Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver injury ranging from simple steatosis to steatohepatitis, fibrosis, and cirrhosis. Whereas simple steatosis has a benign clinical course, steatohepatitis is a recognized cause of progressive liver fibrosis and can develop into cirrhosis. NAFLD and nonalcoholic steatohepatitis (NASH) are the two most common chronic liver diseases in United States general population with a prevalence of 20% and 3%, respectively. Hepatic steatosis is frequently associated with obesity, type 2 diabetes, and hyperlipidemia with insulin resistance as a key pathogenic factor. A two-hit theory best describes the progression from simple steatosis to NASH, fibrosis, or cirrhosis. These two hits consist of the accumulation of excessive hepatic fat primarily owing to insulin resistance, and oxidative stress owing to reactive oxygen species (ROS). Mitochondria are the major cellular source of ROS in cases of NASH. Currently, treatment is focused on modifying risk factors such as obesity, diabetes mellitus, and hyperlipidemia. Antioxidants such as vitamin E, N-acetylcysteine, betaine, and others may be beneficial in the treatment of NASH.     

非酒精性脂肪肝的基因研究

非酒精性脂肪肝（NAFLD）的发病率及脂肪性肝炎（NASH）的发生率与种族、民族和家族密切相关。脂肪性肝病是一组遗传-环境-代谢应激相关性的疾病,近年来NAFLD与遗传和基因的关系越来越受到人们的重视,研究NAFLD的基因应从肥胖、脂肪酸代谢、胰岛素抵抗等与NAFLD有关的环节的相关基因着手。     

非酒精性脂肪性肝病超声诊断

以非酒精性脂肪性肝病(NAFLD)为代表的代谢性脂肪性肝炎,系以内脏脂肪蓄积为关键介质导致的肝脏炎性反应和纤维化[1].本病的超声影像表现为肝脏脂肪累积和肝细胞脂肪交性的非特异性反应,当肝脏脂肪累积>5%时便可显示脂肪肝声像而资为超声诊断依据.实践证明,现代超声诊断技术便捷于粗略评价脂肪肝.因其操作简便,费用相对低廉,加之无损伤、非介入性特点,被检患者乐于接受,而首选适用于广大代谢综合征人群之筛检.