非酒精性脂肪肝的整体治疗方法

Ananta Shrestha, Shrijana Pradhananga
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引用次数: 0

摘要

非酒精性脂肪性肝病(NAFLD),在未来几十年内,有望成为终末期肝病和肝癌最常见的病因,超过所有其他病因。城市化和现代生活方式导致NAFLD在全球流行,全球患病率惊人。其多系统累及表现为代谢综合征、糖尿病、心血管疾病、终末期肝病以及肝脏和肝外恶性肿瘤。缺乏有希望的治疗方法来阻止NAFLD的疾病进展是一个挑战,不仅限于肝脏疾病,而且涉及其他器官。考虑到NAFLD患者的发病率和死亡率是由肝脏以外的疾病引起的,期望药物治疗对NAFLD患者的总生存期有任何显著影响是不现实的。以肝脏为中心的方法管理NAFLD将是徒劳的,除非以整体的方式处理问题。生活方式的改变在预防和治疗与代谢综合征相关的各种疾病(包括NAFLD)方面已被反复评估。尽管生活方式干预在预防和治疗NAFLD的不同表现方面价格低廉且非常有效,但往往未能引起患者和医生的足够兴趣。本综述旨在强调该疾病的多效性、现有药物治疗的局限性以及强调生活方式干预是全面治疗NAFLD患者的唯一途径的证据。如何引用本文:Shrestha A, Pradhananga S.非酒精性脂肪肝的整体治疗方法。中华肝病与胃肠病杂志,2010;12(增刊1):551 - 558。
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Holistic Approach in the Management of Nonalcoholic Fatty Liver Disease.

Nonalcoholic fatty liver disease (NAFLD), in a few decades, is expected to be the commonest cause of end-stage liver disease and liver cancer surpassing all other etiologies. Urbanization and modern lifestyle have led to global epidemic of NAFLD with alarming prevalence rates across the globe. Its multisystemic involvement manifests as metabolic syndrome, diabetes, cardiovascular disease, end-stage liver disease, and hepatic and extrahepatic malignancies. The absence of promising therapy for halting disease progression in NAFLD is a challenge that is not only limited to liver disease but also other organs involved. It is unrealistic to expect any significant impact of pharmacotherapies in overall survival of NAFLD patients, given that the morbidity and mortality in these patients are contributed by conditions other than that of liver. Liver-centric approach in managing NAFLD will be futile unless the problem is dealt in a holistic manner. Lifestyle modifications have been repeatedly appraised in prevention and treatment of various diseases linked to metabolic syndrome including NAFLD. Despite being inexpensive and highly efficacious in prevention and treatment of different manifestations of NAFLD, lifestyle intervention often fails to gather sufficient interest among patients and physicians alike. This review intends to highlight pleiotropic nature of this disease, limitations of currently available pharmacotherapies and evidence that emphasizing lifestyle intervention is the only way to holistically deal in patients with NAFLD.

How to cite this article: Shrestha A, Pradhananga S. Holistic Approach in the Management of Nonalcoholic Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S51-S58.

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