Progress in treatment of nonalcoholic fatty liver disease
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摘要: 非酒精性脂肪性肝病(NAFLD)的发病随肥胖流行迅速增加,但特效治疗方法缺乏。首先评述了生活方式修正不同实施策略的可能临床获益、提高干预效果的方法和存在问题;其次简单介绍了减肥手术的适应证和主要研究方向;最后对维生素E、法尼酸X受体激动剂、肠道微生态制剂、多不饱和脂肪酸、胰高糖素样肽-1受体激动剂、己酮可可碱等几类有前景的药物进行了较全面的介绍。目前获得的这些临床证据和来自基础领域的有关研究进展表明:生活方式修正是所有NAFLD患者治疗的基础,但实施方案须要改进以提高干预效果;减肥手术是无禁忌症病态肥胖NAFLD患者的有效治疗选择之一;药物治疗则应选择性用于确诊的非酒精性脂肪性肝炎人群。
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关键词:
- 脂肪肝
Abstract: The incidence of nonalcoholic fatty liver disease ( NAFLD) increases with the prevalence of obesity, but specific treatment for this disease is lacking. First, the possible clinical benefits from different strategies of lifestyle modification, as well as the methods for improving intervention effect and existing problems, are reviewed. Second, the indications for bariatric surgery and the main research directions are briefly presented. Finally, several promising drugs including vitamin E, farnesoid X receptor agonist, intestinal probiotics, polyunsaturated fatty acids, glucagon-like peptide-1 receptor agonist, and pentoxifylline are elaborated on. The currently acquired clinical evidence and progress in basic research suggest that lifestyle modification is the basis for treatment in all patients with NAFLD, but better schemes are needed to improve the intervention effect; bariatric surgery is one of the effective therapies for NAFLD patients with morbid obesity who have no relevant contraindications; drug treatment should be selectively applied to the population with a confirmed diagnosis of NAFLD.-
Key words:
- fatty liver
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