浅谈营养不良与肝脏疾病的关系及研究进展

Discussion on the Relationship between Malnutrition and Liver Disease and Its Research Progress

摘要: 肝脏是人体重要的代谢器官，并且在多种复杂的生化过程中发挥着重要作用，包括大量营养物质的代谢、维生素的活化和储存，以及废物的解毒和排泄等。在肝脏疾病的早期阶段，肝脏仍能履行其许多功能，患者可能表现出很少或没有症状，但随着肝病疾病的进展，代谢改变将变得更加明显，常导致严重的并发症，包括腹水、食管静脉曲张及静脉曲张出血、肝性脑病、自发性细菌性腹膜炎和肝肾综合征等。由于肝脏维生素合成、激活和储存受损，以及由于食欲不振、胃瘫、腹水引起的早饱和慢性疾病导致的摄入不足，患者出现营养不良的风险也在增加。营养不良的不同程度也被认为是与肝脏疾病的严重程度有关，了解不同形式的肝脏疾病相关的营养不良机制变化及危险因素，可以为临床医生提供各种肝脏疾病的营养不良机制及其危险因素，及时给予预防和营养支持，降低并发症的发生率。本综述的目的是研究不同肝脏疾病的发生营养不良的机制以及与疾病的关系。

Abstract: Liver is an important metabolic organ in human bodies and plays an important role in a variety of complex biochemical processes, including the metabolism of large amounts of nutrients, activation and storage of vitamins, as well as waste detoxification and excretion. In the early stages of liver disease, the liver is still able to perform many functions and patients may show few or no symptoms, but metabolic changes will become more pronounced as liver disease progresses often leads to serious complications, including ascites, esophageal varices and variceal hemorrhage, hepatic encephalopathy, spontaneous bacterial peritonitis and hepatorenal syndrome. Patients are also at increasing risk of malnutrition due to impaired liver vitamin synthesis, activation, and storage, as well as inadequate oral intake due to chronic diseases of premature saturation caused by loss of appetite, gastroparalysis, and ascites. Malnutrition of different level is also thought to be associated with the severity of liver disease. Understanding the different forms of liver diseases related to malnutrition mechanism change and risk factors can provide clinicians with a variety of nutrition mechanism of liver disease and its risk factors, prevention and nutritional support in time, reduce the incidence of complications. The purpose of this review is to investigate the mechanisms underlying malnutrition in different liver diseases and the associated risk factors in this disease.