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非酒精性脂肪性肝病的治疗进展

牛海艳 李海 丁玉平

引用本文:
Citation:

非酒精性脂肪性肝病的治疗进展

DOI: 10.3969/j.issn.1001-5256.2018.02.048
基金项目: 

武警后勤学院博士启动基金(WHB201517); 

详细信息
  • 中图分类号: R575.5

Advances in the treatment of nonalcoholic fatty liver disease

Research funding: 

 

  • 摘要:

    非酒精性脂肪性肝病(NAFLD)在我国的发病率逐年攀升,已是严重影响我国居民健康的常见慢性疾病。介绍了生活方式的干预在NAFLD治疗中的地位,简述了药物在NAFLD治疗中的种类与价值,总结了改善肠道菌群在NAFLD治疗中的方法与途径,分析了外科手术干预在NAFLD治疗中的临床获益与经济效价。指出加强对NAFLD患者的有效管理可能是未来对该疾病治疗的一个新研究方向。

     

  • [1]CALDWELL S, ARGO C.The natural history of non-alcoholic fatty liver disease[J].Dig Dis, 2010, 28 (1) :162-168.
    [2]BYRNE CD, TARGHER G.NAFLD:a multisystem disease[J].J Hepatol, 2015, 62 (Suppl 1) :s47-s64.
    [3]VILAR-GOMEZ E, MARTINEZ-PEREZ Y, CALZADILLABERTOT L, et al.Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis[J].Gastroenterology, 2015, 149 (2) :367-378.
    [4]HANNAH WN JR, HARRISON SA.Lifestyle and Dietary interventions in the management of nonalcoholic fatty liver disease[J].Dig Dis Sci, 2016, 61 (5) :1365-1374.
    [5]JUMP DB, DEPNER CM, TRIPATHY S, et al.Potential for dietaryω-3fatty acids to prevent nonalcoholic fatty liver disease and reduce the risk of primary liver cancer[J].Adv Nutr, 2015, 6 (6) :694-702.
    [6]MARKOVA M, PIVOVAROVA O, HORNEMANN S, et al.Isocaloric diets high in animal or plant protein reduce liver fat and inflammation in individuals with type 2 diabetes[J].Gastroenterology, 2017, 152 (3) :571-585.
    [7]MARTINEZ-GONZALEZ MA, MARTIN-CALVO N.Mediterranean diet and life expectancy;beyond olive oil, fruits, and vegetables[J].Curr Opin Clin Nutr Metab Care, 2016, 19 (6) :401-407.
    [8]KONTOGIANNI MD, TILELI N, MARGARITI A, et al.Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease[J].Clin Nutr, 2014, 33 (4) :678-683.
    [9]WIJARNPREECHA K, THONGPRAYOON C, UNGPRASERT P.Coffee consumption and risk of nonalcoholic fatty liver disease:a systematic review and meta-analysis[J].Eur J Gastroenterol Hepatol, 2017, 29 (2) :e8-e12.
    [10]Group of Fatty Liver and Alcoholic Liver Diseases, Society of Hepatology, Chinese Medical Association.Guidelines for management of non-alcoholic fatty liver disease[J].J Clin Hepatol, 2010, 26 (2) :120-124. (in Chinese) 中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南[J].临床肝胆病杂志, 2010, 26 (2) :120-124.
    [11]ORCI LA, GARIANI K, OLDANI G, et al.Exercise-based interventions for nonalcoholic fatty liver disease:a Meta-analysis and Meta-regression[J].Clin Gastroenterol Hepatol, 2016, 14 (10) :1398-1411.
    [12]KISTLER KD, BRUNT EM, CLARK JM, et al.Physical activity recommendations, exercise intensity, and histological severity of nonalcoholic fatty liver disease[J].Am J Gastroenterol, 2011, 106 (3) :460-468.
    [13]CHALASANI N, YOUNOSSI Z, LAVINE JE, et al.The diagnosis and management of non-alcoholic fatty liver disease:practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology[J].Hepatology, 2017.[Epub ahead of print]
    [14]RATZIU V, HARRISON SA, FRANCQUE S, et al.Elafibranor, an agonist of the peroxisome proliferator-activated receptor-αand-δ, induces resolution of nonalcoholic steatohepatitis without fibrosis worsening[J].Gastroenterology, 2016, 150 (5) :1147-1159.
    [15]SAID A, AKHTER A.Meta-analysis of randomized controlled trials of pharmacologic agents in non-alcoholic steatohepatitis[J].Ann Hepatol, 2017, 16 (4) :538-547.
    [16]SATHYANARAYANA P, JOGI M, MUTHUPILLAI R, et al.Effects of combined exenatide and pioglitazone therapy on hepatic fat content in type 2 diabetes[J].Obesity (Silver Spring) , 2011, 19 (12) :2310-2315.
    [17]OHKI T, ISOGAWA A, IWAMOTO M, et al.The effectiveness of liraglutide in nonalcoholic fatty liver disease patients with type 2 diabetes mellitus compared to sitagliptin and pioglitazone[J].Scientific World J, 2012, 2012:496453.
    [18]IWASAKI T, YONEDA M, INAMORI M, et al.Sitagliptin as a novel treatment agent for non-alcoholic Fatty liver disease patients with type 2 diabetes mellitus[J].Hepatogastroenterology, 2011, 58 (112) :2103-2105.
    [19]CUI J, PHILO L, NGUYEN P, et al.Sitagliptin vs.placebo for non-alcoholic fatty liver disease:a randomized controlled trial[J].J Hepatol, 2016, 65 (2) :369-376.
    [20]WANG CJ, HUANG RX, JIANG YS, et al.Effect of saxagliptin on nonalcoholic fatty liver in patients with diabetes mellitus[J].Chongqing Med, 2017, 46 (11) :1490-1491, 1494. (in Chinese) 王成剑, 黄荣曦, 姜英松, 等.DPP-4抑制剂沙格列汀对糖尿病非酒精性脂肪肝的作用研究[J].重庆医学, 2017, 46 (11) :1490-1491, 1494
    [21]de KEYSER CE, KOEHLER EM, SCHOUTEN JN, et al.Statin therapy is associated with a reduced risk of non-alcoholic fatty liver in overweight individuals[J].Dig Liver Dis, 2014, 46 (8) :720-725.
    [22]KARGIOTIS K, ATHYROS VG, GIOULEME O, et al.Resolution of non-alcoholic steatohepatitis by rosuvastatin monotherapy in patients with metabolic syndrome[J].World J Gastroenterol, 2015, 21 (25) :7860-7868.
    [23]DONGIOVANNI P, PETTA S, MANNISTO V, et al.Statin use and non-alcoholic steatohepatitis in at risk individuals[J].J Hepatol, 2015, 63 (3) :705-712.
    [24]CHANG BX, LI BS, ZOU ZS.An excerpt of EASL-EASDEASO clinical practice guidelines for the management of non-alcoholic fatty liver disease (2016) [J].J Clin Hepatol, 2016, 32 (8) :1450-1454. (in Chinese) 常彬霞, 李保森, 邹正升.《2016年欧洲肝病学会、欧洲糖尿病学会和欧洲肥胖学会临床实践指南》摘译[J].临床肝胆病杂志, 2016, 32 (8) :1450-1454.
    [25]ATHYROS VG, ALEXANDRIDES TK, BILIANOU H, et al.The use of statins alone, or in combination with pioglitazone and other drugs, for the treatment of non-alcoholic fatty liver disease/nonalcoholic steatohepatitis and related cardiovascular risk.An expert panel statement[J].Metabolism, 2017, 71:17-32.
    [26]EL-HAGGAR SM, MOSTAFA TM.Comparative clinical study between the effect of fenofibrate alone and its combination with pentoxifylline on biochemical parameters and liver stiffness in patients with nonalcoholic fatty liver disease[J].Hepatol Int, 2015, 9 (3) :471-479.
    [27]YU D, SHU XO, XIANG YB, et al.Higher dietary choline intake is associated with lower risk of nonalcoholic fatty liver in normalweight Chinese women[J].J Nutr, 2014, 144 (12) :2034-2040.
    [28]ZHANG H, HAN J, ZHANG XL.An excerpt of the Japanese Society of Gastroenterology of evidence-based clinical practice guidelines for liver cirrhosis (2015) [J].J Clin Hepatol, 2016, 32 (9) :1659-1663. (in Chinese) 张红, 韩静, 张晓岚.《2015年日本胃肠病学会肝硬化循证医学临床实践指南》摘译[J].临床肝胆病杂志, 2016, 32 (9) :1659-1663
    [29]NEUSCHWANDER-TETRI BA, LOOMBA R, SANYAL AJ, et al.Farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic, non-alcoholic steatohepatitis (FLINT) :a multicentre, randomised, placebo-controlled trial[J].Lancet, 2015, 385 (9972) :956-965.
    [30]FRIEDMAN S, SANYAL A, GOODMAN Z, et al.Efficacy and safety study of cenicriviroc for the treatment of non-alcoholic steatohepatitis in adult subjects with liver fibrosis:CENTAUR Phase 2 b study design[J].Contemp Clin Trials, 2016, 47:356-365.
    [31]ARAB JP, KARPEN SJ, DAWSON PA, et al.Bile acids and nonalcoholic fatty liver disease:Molecular insights and therapeutic perspectives[J].Hepatology, 2017, 65 (1) :350-362.
    [32]ALTAMIRANO-BARRERA A, BARRANCO-FRAGOSO B, MNDEZ-SNCHEZ N.Management strategies for liver fibrosis[J].Ann Hepatol, 2017, 16 (1) :48-56.
    [33]JING J, YU JF, ZHANG TF.Curative effect of Yerba Mate improving phlegm and blood stasis, and blood lipid level of NAFLD[J].Chin J Med Offic, 2017, 45 (7) :683-684. (in Chinese) 井静, 于京芳, 张铁峰.马黛茶改善非酒精性脂肪性肝病痰瘀互结证血脂水平疗效分析[J].临床军医杂志, 2017, 45 (7) :683-684.
    [34]ZHU D, SUN TT, CHEN LY.Treatment of nonalcoholic fatty liver disease in Jingui Yaolue[J].Changchun Univ Chin Med, 2016, 32 (2) :423-425, 429. (in Chinese) 朱丹, 孙婷婷, 陈兰羽.《金匮要略》诸方治疗非酒精性脂防性肝病进展[J].长春中医药大学学报, 2016, 32 (2) :423-425, 429.
    [35]LEUNG C, RIVERA L, FURNESS JB, et al.The role of the gut microbiota in NAFLD[J].Nat Rev Gastroenterol Hepatol, 2016, 13 (7) :412-425.
    [36]XIAO L, YANG L.Gut microbiota and nonalcoholic fatty liver disease[J].J Clin Hepatol, 2017, 33 (4) :774-779. (in Chinese) 肖丽, 杨玲.肠道菌群与非酒精性脂肪性肝病的关系[J].临床肝胆病杂志, 2017, 33 (4) :774-779.
    [37]BUSS C, VALLE-TOVO C, MIOZZO S, et al.Probiotics and synbiotics may improve liver aminotransferases levels in non-alcoholic fatty liver disease patients[J].Ann Hepatol, 2014, 13 (5) :482-488.
    [38]GULLON B, GULLON P, TAVARIA FK, et al.Assessment of the prebiotic effect of quinoa and amaranth in the human intestinal ecosystem[J].Food Funct, 2016, 7 (9) :3782-3788.
    [39]FUJISAKA S, USSAR S, CLISH C, et al.Antibiotic effects on gut microbiotaand metabolism are host dependent[J].J Clin Invest, 2016, 126 (12) :4430-4443.
    [40]HU J, LUO H, JIANG Y, et al.Dietary capsaicin and antibiotics act synergistically to reduce non-alcoholic fatty liver disease induced by high fat diet in mice[J].Oncotarget, 2017, 8 (24) :38161-38175.
    [41]COBBOLD JFL, ATKINSON S, MARCHESI JR, et al.Rifaximin in non-alcoholic steatohepatitis:an open-label pilot study[J].Hepatol Res, 2017.[Epub ahead of print]
    [42]GOODRICH JK, WATERS JL, POOLE AC, et al.Human genetics shape the gut microbiome[J].Cell, 2014, 159 (4) :789-799.
    [43]LI SS, ZHU A, BENES V, et al.Durable coexistence of donor and recipient strains after fecal microbiotatransplantation[J].Science, 2016, 352 (6285) :586-589.
    [44]ZHOU D, PAN Q, SHEN F, et al.Total fecal microbiota transplantation alleviates high-fat diet-induced steatohepatitis in mice via beneficial regulation of gut microbiota[J].Sci Rep, 2017, 7 (1) :1529.
    [45]HAFEEZ S, AHMED MH.Bariatric surgery as potential treatment for nonalcoholic fatty liver disease:a future treatment by choice or by chance?[J].J Obes, 2013, 2013:839275.
    [46]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.
    [47]KLEBANOFF MJ, COREY KE, CHHATWAL J, et al.Bariatric surgery for nonalcoholic steatohepatitis:a clinical and cost-effectiveness analysis[J].Hepatology, 2017, 65 (4) :1156-1164.
    [48]BURRA P, GERMANI G.Orthotopic liver transplantation in nonalcoholic fatty liver disease patients[J].Rev Recent Clin Trials, 2014, 9 (3) :210-216.
    [49]UNGER LW, HERAC M, STAUFER K, et al.The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis:a retrospective case-control study[J].Eur J Gastroenterol Hepatol, 2017, 29 (3) :309-316.
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  • 出版日期:  2018-02-20
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