儿童非酒精性脂肪性肝病的治疗

李泽圣; 吴捷

doi:10.3969/j.issn.1001-5256.2019.04.047

儿童非酒精性脂肪性肝病的治疗

DOI: 10.3969/j.issn.1001-5256.2019.04.047

李泽圣,
吴捷

中国医科大学附属盛京医院小儿消化内科

详细信息

中图分类号: R725.7
计量
- 文章访问数: 1051
- HTML全文浏览量: 64
- PDF下载量: 357
- 被引次数: 0
出版历程
- 出版日期: 2019-04-20

Advances in the treatment of nonalcoholic fatty liver disease in children

Li ZeSheng,
Wu Jie

Department of Pediatric Gastroenterology, Shengjing Hospital of China Medical University

摘要

摘要: 非酒精性脂肪性肝病(NAFLD)是指单纯性脂肪肝以及非酒精性脂肪性肝炎、肝纤维化甚至肝硬化等一系列病变的综合征。随着生活水平的提高,肥胖儿童逐渐增多,NAFLD的检出率也呈上升趋势,儿童NAFLD的治疗主要是改变饮食和生活方式,辅以药物治疗。回顾近年来儿童NAFLD治疗方面的进展。
- 非酒精性脂肪性肝病 /
- 婴儿 /
- 儿童 /
- 青少年 /
- 治疗学 /
- 综述
Abstract: Nonalcoholic fatty liver disease ( NAFLD) refers to a syndrome of a series of lesions such as simple fatty liver disease, nonalcoholic steatohepatitis, liver fibrosis, and even liver cirrhosis. With the improvement of living standards, there is an increasing number of children with obesity, and the detection rate of NAFLD also tends to increase. Major treatment methods for children with NAFLD include the changes in diet and lifestyle and medication. The article reviews the advances in the treatment of NAFLD in children in recent years.
- non-alcoholic fatty liver disease /
- infant /
- child /
- adolescent /
- therapeutics /
- review

HTML全文

参考文献(37)

[1]GUO ZQ, WANG QY, QI XS, et al. Recommendations for the diagnosis and management of nonalcoholic fatty liver disease:practice guidance from the American Association for the Study of Liver Diseases (2017) [J]. J Clin Hepatol, 2017, 33 (12) :2275-2277. (in Chinese) 郭泽淇, 王倩怡, 祁兴顺, 等.《2017年美国肝病学会非酒精性脂肪性肝病诊疗指导》摘译[J].临床肝胆病杂志, 2017, 33 (12) :2275-2277.

[2] WANG ZL. A review of nonalcoholic fatty liver disease in children[J]. Health literature, 2017, 10:165. (in Chinese) 王泽兰.关于儿童非酒精性脂肪肝的综述[J].保健文汇, 2017, 10:165.

[3]NOBILI V, MANCO M, DEVITO R, et al. Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease:A randomized, controlled trial[J]. Hepatology, 2008, 48 (1) :119-128.

[4]MACAVEI B, BABAN A, DUMITRASCU DL, et al. Psychological factors associated with NAFLD/NASH:A systematic review[J].Eur Rev Med Pharmacol Sci, 2016, 20 (24) :5081-5097.

[5]HAUFE S, ENGELI S, KAST P, et al. Randomized comparison of reduced fat and reduced carbohydrate hypocalofic diets on intrahepatic fat in overweight and obese human subjects[J].Hepatology, 2011, 53 (5) :1504-1514.

[6]BARATTA F, PASTORI D, POLIMENI L, et al. Adherence to mediterranean diet and non-alcoholic fatty liver disease:Effect on Insulin Resistance[J]. Am J Gastroenterol, 2017, 112 (12) :1832-1839.

[7]CAKIR M, AKBULUT UE, OKTEN A. Association between adherence to the mediterranean diet and presence of nonalcoholic fatty liver disease in children[J]. Child Obes, 2016, 12 (4) :279-285.

[8]KEATING SE, HACKETT DA, PARKER HM, et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity[J]. J Hepatol, 2015, 63 (1) :174-182.

[9]DIRK J, van der WINDT DJ, SUD V, et al. The effects of physical exercise on fatty liver disease[J]. Gene expression, 2018, 18 (2) :89-101.

[10]JIA GY, HANG T, GAO L, et al. Effect of aerobic exercise and resistance exercise in improving non-alcoholic fatty liver disease:A randomized controlled trial[J]. Chin J Hepatol, 2018, 26 (1) :34-41. (in Chinese) 贾国瑜, 韩涛, 高磊, 等.有氧运动和抗阻运动改善非酒精性脂肪肝的随机对照研究[J].中华肝脏病杂志, 2018, 26 (1) :34-41.

[11]NOBILI V, MANCO M, CIAMPALINI P, et al. Metformin use in children with nonalcoholic fatty liver disease:An open-label, 24-month, observational pilot study[J]. Clin Ther, 2008, 30 (6) :1168-1176.

[12]MAURAS N, DELGIORNO C, HOSSAIN J, et al. Metformin use in children with obesity and normal glucose toleranceeffects on cardiovascular markers and intrahepatic fat[J]. J Pediatr Endocrinol Metab, 2012, 25 (1-2) :33-40.

[13]OZTURK ZA, KADAYIFCI A. Insulin sensitizers for the treatment of non-alcoholic fatty liver disease[J]. World J Hepatol, 2014, 6 (4) :199-206.

[14]LAVINE JE, SCHWIMMER JB, van NATTA ML, et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents:The TONIC randomized controlled trial[J]. JAMA, 2011, 305 (16) :1659-1668.

[15]Group of Endocrinology, Genetics and Metabolism, Society of Pediatrics, Chinese Medical Association; Digestive Group, Society of Pediatrics, Chinese Medical Association; Adolescent Medical Professional Committee, Society of Pediatrics, Chinese Medical Association, et al. Expert consensus on diagnosis and treatment of nonalcoholic fatty liver disease in children[J]. Chin J Pract Pediatr, 2018, 33 (7) :487-492. (in Chinese) 中华医学会儿科学分会内分泌遗传代谢学组, 中华医学会儿科学分会消化学组, 中华医学会儿科学分会青春期医学专业委员会, 等.儿童非酒精性脂肪肝病诊断与治疗专家共识[J].中国实用儿科杂志, 2018, 33 (7) :487-492.

[16]SANYAL AJ, CHALASANI N, KOWDLEY KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis[J]. N Engl J Med, 2010, 363 (12) :1185-1186.

[17]VAJRO P, MANDATO C, FRANZESE A, et al. Vitamin E treatment in pediatric obesity-related liver disease:A randomized study[J]. J Pediatr Gastroenterol Nutr, 2004, 38 (1) :48-55.

[18]LAVINE JE. Vitamin E treatment of nonalcoholic steatohepatitis in children:A pilot study[J]. J Pediatr, 2000, 136 (6) :734-738

[19]ABNER EL, SCHMITT FA, MENDIONDO MS, et al. Vitamin E and all-cause mortality:A meta-analysis[J]. Curr Aging Sci, 2011, 4 (2) :158-170.

[20]LI YW, HU YH, ZHU TT, et al. Clinical efficacy of compound glycyr-rhizin tablets in the treamlent of children with nonalcoholie fatty fiver disease[J]. Chin J Pract Pediatr, 2017, 19 (5) :505-509. (in Chinese) 李毓雯, 胡毓华, 朱甜甜, 等.复方甘草酸苷片治疗儿童非酒精性脂肪性肝病疗效观察[J].中国实用儿科杂志, 2017, 19 (5) :505-509.

[21]Expert Committee on the Diagnosis and Management of Fatty Liver Disease, Chinese Medical Association. Recommendation for the standardization of diagnosis and treatment of fatty liver disease[J]. J Clin Hepatol, 2013, 29 (9) :652-655. (in Chinese) 中国医师协会脂肪性肝病专家委员会.脂肪性肝病诊疗规范化的专家建议[J].临床肝胆病杂志, 2013, 29 (9) :652-655.

[22]BARLOW SE, EXPERT C. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity:Summary report[J].Pediatrics, 2007, 120 (4) :164-192.

[23]ESLAMPARAST T, EGHTESAD S, et al. Probiotics and non alcoholic fatty liver disease[J]. Middle East J Dig Dis, 2013, 5 (3) :129-136.

[24]ALISI A, BEDOGNI G. Randomised clinical trial:The benefical effects of VSL#3 in obese children with non-alcoholic steatohepatitis[J]. Aliment Pharmacol Ther, 2014, 39 (11) :1276-1285.

[25]VAJRO P, MANDATO C. Effects of Lactobacillus rhamnosus strain GG in prdiatric obesity-related liver disease[J]. J Pediatr Gastroenterol Nutr, 2011, 52 (6) :740-743.

[26]PIRGON O, CEKMEZ F, BILGIN H, et al. Low 25-hydroxyvitamin D level is associated with insulin sensitivity in obese adolescents with non-alcoholic fatty liver disease[J]. Obes Res Clin Pract, 2013, 7 (4) :275-283.

[27]EI-SHERBINY M, ELDOSOKY M, EI-SHAFEY M, et al. Vitamin D nanoemulsion enhances hepatoprotective effect of conventional vitamin D in rats fed with a high-fat diet[J].Chem-Biol Interact, 2018, 25 (288) :65-75.

[28]KELISHADI R, SALEK S, SALEK M, et al. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome:A triple-masked controlled trial[J]. J Pediatr (Rio J) , 2014, 90 (1) :28-34.

[29]CAVALIER E, FACHW, SOUBERBIELLE JC. A randomised, double-blinded, placebo-controlled, parallel study of vitamin D3 supplementation with different schemes based on multiples of 25, 000IU doses[J]. Int J Endocrinol, 2013, 2013:327265.

[30]BOZIC M, GUZMN C, BENET M, et al. Hepatocyte vitamin D receptor regulates lipid metabolism and mediates experimental diet-induced steatosis[J]. J Hepatol, 2016, 65 (4) :748-757.

[31]WEI GC, HE JY. Traditional Chinese medicine intervention to nonalcoholic fatty liver disease based on physique identi cation[J]. J Changchun Univ Chin Med, 2018, 34 (3) :518-521. (in Chinese) 魏功昌, 何瑾瑜.中医体质辨识治疗非酒精性脂肪性肝病[J].长春中医药大学学报, 2018, 34 (3) :518-521.

[32]CUI JJ, ZHAO WX. Professor zhao wenxia's experience in the treatment of non-alcoholic fatty liver disease[J]. Chin Med Modern Distance Educ of China, 2014, 12 (22) :26-27. (in Chinese) 崔健娇, 赵文霞.赵文霞教授治疗非酒精性脂肪性肝病经验总结[J].中国中医药现代远程教育, 2014, 12 (22) :26-27.

[33] SAI YT. Clinical observation of combined Chinese and Western medicine in the treatment of non-alcoholic fatty liver disease[J. Med Inf, 2012, 25 (1) :129-130. (in Chinese) 赛咏婷.中西医结合治疗非酒精性脂肪肝疗效观察[J].医学信息, 2012, 25 (1) :129-130.

[34]IMPRIALOS K, STAVROPOULOS K, BOULOUKOU S, et al.Current and potential future pharmacological approaches for non-alcoholic fatty liver disease[J]. Curr Vasc Pharmacol, 2018, 16 (3) :276-288.

[35]BOWER G, TOMA T, HARLING L, et al. Bariatric surgery and non-alcoholic fatty liver disease:A systematic review of liver biochemistry and histology[J]. Obes Surg, 2015, 25 (12) :2280-2289.

[36]DYSON J, DAY C. Treatment of non-alcoholic fatty liver disease[J]. Dig Dis, 2014, 32 (5) :597-604.

[37]NICKEL F, TAPKING C, BENNER L, et al. Bariatric surgery as an efficient treatment for non-alcoholic fatty liver disease in a prospective study with 1-year follow-up:Bari Scan study[J]. Obes Surg, 2018, 28 (5) :1342-1350.

施引文献

资源附件(0)

访问统计