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非酒精性脂肪肝(NAFLD)是西方国家最常见肝病,在我国的发病率日益上升,且呈低龄化趋势。胰岛素抵抗在NAFLD的发生发展中起关键作用。目前暂无批准治疗NAFLD的药物,但许多治疗方法是有益的。生活方式改变仍是治疗NAFLD的基础。体质量减轻可改善肝脂肪变性,且体质量减轻10%甚至可以改善脂肪肝炎。此外,常用的胰岛素增敏剂、抗氧化剂和调脂抗炎药物同样是治疗NAFLD比较有前景的药物。肠促胰岛素疗法有可能改善肥胖和糖尿病的肝脂肪变性。由此研发的新型糖尿病治疗药物胰高血糖素样肽1类似物相对于NAFLD传统治疗手段表现出了更广阔的潜在价值。同时,减重手术的不断发展,对治疗NAFLD合并病态肥胖患者具有独特的临床意义。
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in western countries. The incidence of non-alcoholic fatty liver disease (NAFLD) in our country is increasing day by day. Insulin resistance plays a key role in the development of NAFLD. There are currently no drugs approved for the treatment of NAFLD, but many therapies are beneficial. Lifestyle changes are still the cornerstone of treatment for NAFLD. Weight loss can improve hepatic steatosis, and weight loss of 10% can even improve fatty hepatitis. In addition, commonly used insulin sensitizers, antioxidants and lipid-lowering anti-inflammatory drugs are also more promising treatment of NAFLD drugs. Intestinal insulin therapy may improve hepatic steatosis in obesity and diabetes. The novel diabetic drug glucagon-like peptide 1 analogue developed thus shows a much broader potential value than the traditional treatment of NAFLD. At the same time, the continuous development of weight loss surgery has unique clinical significance for the treatment of NAFLD patients with morbid obesity.