他汀类药物在代谢相关脂肪性肝病治疗中的应用

孙丹丹; 李睿思; 扈晓宇

doi:10.12449/JCH260322

他汀类药物在代谢相关脂肪性肝病治疗中的应用

DOI: 10.12449/JCH260322

孙丹丹¹,
李睿思¹,
扈晓宇^{1, 2, , ,}

1.
成都中医药大学临床医学院，成都 610072
2.
成都中医药大学附属医院肝病感染科，成都 610072

基金项目:

国家自然科学基金 (81973840);

四川省中医药管理局重大科技项目 (2021XYCZ004)

利益冲突声明：本文无任何利益冲突。

作者贡献声明：孙丹丹负责设计论文框架，起草论文；李睿思负责论文修改；扈晓宇负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
扈晓宇， xiaoyuhu_dr@sina.com （ORCID： 0009-0002-7184-3278）

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出版历程
- 收稿日期: 2025-06-23
- 录用日期: 2025-08-04
- 出版日期: 2026-03-25

Application of statins in the treatment of metabolic dysfunction-associated fatty liver disease

Dandan SUN¹,
Ruisi LI¹,
Xiaoyu HU^{1, 2
, ,
,}

1.
College of Clinical Medicine，Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China
2.
Department of Hepatology and Infectious Diseases，The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China

Research funding:

National Natural Science Foundation of China (81973840);

Major Science and Technology Project Funding Project of Sichuan Provincial Administration of Traditional Chinese Medicine (2021XYCZ004)

More Information

Corresponding author: HU Xiaoyu， xiaoyuhu_dr@sina.com （ORCID： 0009-0002-7184-3278）

摘要

摘要: 代谢相关脂肪性肝病（MAFLD）及其进展形式——代谢相关性脂肪性肝炎（MASH）已成为全球慢性肝病的主要病因，其发病率持续上升，与肥胖、2型糖尿病等代谢紊乱密切相关。MAFLD的核心发病机制涉及胰岛素抵抗、脂代谢异常及慢性炎症反应，可进展为MASH，导致肝纤维化、肝硬化甚至肝细胞癌。目前，针对MAFLD的有效药物治疗仍有限。本文基于PRISMA指南，系统综述他汀类药物在MAFLD治疗中的作用。研究表明，他汀类药物不仅能改善血脂谱和肝酶水平，还对合并心血管疾病或2型糖尿病等患者具有良好获益，且长期使用还可以降低肝细胞癌风险。然而，其潜在的肝毒性及肌病风险需警惕，因此临床应个体化用药并定期监测肝功能。
- 羟甲基戊二酰基CoA还原酶抑制剂 /
- 代谢相关脂肪性肝病 /
- 治疗学
Abstract: Metabolic dysfunction-associated fatty liver disease （MAFLD） and its progressive form metabolic dysfunction-associated steatohepatitis （MASH） have become the leading causes of chronic liver diseases worldwide， and the incidence rate of MAFLD continues to rise， which is closely associated with metabolic disorders such as obesity and type 2 diabetes. The core pathogenesis of MAFLD involves insulin resistance， abnormal lipid metabolism， and chronic inflammation， which can progress to MASH and lead to liver fibrosis， liver cirrhosis， and even hepatocellular carcinoma （HCC）. At present， there are still limited effective pharmacotherapies for MAFLD. Based on the PRISMA guidelines， this article systematically reviews the role of statins in MAFLD. Studies have shown that statins not only improve blood lipid profiles and the levels of liver enzyme， but also bring good benefits to patients comorbid with cardiovascular disease or type 2 diabetes， and long-term use can also reduce the risk of HCC. However， the potential risks of hepatotoxicity and myopathy should be taken seriously， which， therefore， requires individualized medication and regular monitoring of liver function in clinical practice.
- Hydroxymethylglutaryl-CoA Reductase Inhibitors /
- Metabolic Dysfunction-Associated Fatty Liver Disease /
- Therapeutics

HTML全文

注： ROS，活性氧；NLRP3，核苷酸结合寡聚结构域样受体家族热蛋白结构域相关蛋白3；caspase-1，胱天蛋白酶1；IL-1β，白细胞介素1β；IL-18，白细胞介素18；MAFLD，代谢相关脂肪性肝病；HMG-CoA，羟基甲基戊二酸酰辅酶A；SCFA，短链脂肪酸；NF-κB，核因子κB；Nrf2，核因子红系2相关因子2；IRS，胰岛素受体底物；AMPK，AMP活化的蛋白质激酶；PPARγ，过氧化物酶体增殖物激活受体γ；LDL-C，低密度脂蛋白胆固醇；TG，甘油三酯。

图 1 他汀类药物治疗MAFLD的作用机制

Figure 1. The mechanism of action of statins in the treatment of MAFLD

下载: 全尺寸图片幻灯片

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