非酒精性脂肪性肝病发病机制及治疗方案研究进展

Research Progress on the Pathogenesis and Treatment of Nonalcoholic Fatty Liver Disease

摘要: 非酒精性脂肪性肝病(NAFLD)包括广泛的病理，从非酒精性脂肪肝(NAFL)，其特征是没有炎症的简单脂肪变性，到非酒精性脂肪性肝炎(NASH)，其特征是肝脏脂肪变性伴有炎症和肝细胞气球形成，可导致晚期纤维化，肝硬化和肝细胞癌。饮食和生活方式的改变被认为是非药物治疗策略；然而，由于NAFLD发病机制复杂，目前的药物治疗主要以致病因素、发病机制的关键环节以及相关的代谢紊乱为靶点。仍然缺乏特定的药物。在临床研究中，常见的NAFLD治疗包括调节葡萄糖和脂质代谢以保护肝脏和抗炎。基于肝肠轴、靶向肠道菌群的NAFLD治疗正在逐步涌现，各种新的代谢调节药物也在临床开发中。因此，本文综述了近年来NAFLD治疗的研究进展。

Abstract: Nonalcoholic fatty liver disease (NAFLD) encompasses a wide range of pathologies, from nonalcoholic fatty liver disease (NAFL), which is characterized by simple steatosis without inflammation, to nonalcoholic steatohepatitis (NASH), which is characterized by hepatic steatosis with inflammation and hepatocyte balloon formation, which can lead to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Dietary and lifestyle changes are considered nonpharmacological treatment strategies; however, due to the complex pathogenesis of NAFLD, current drug treatments mainly target pathogenic factors, key links in the pathogenesis, and related metabolic disorders. There is still a lack of specific medications. In clinical studies, common NAFLD treatments include modulation of glucose and lipid metabolism to protect the liver and anti-inflammatory. NAFLD treatments based on the hepatoenteropathic axis and targeting the intestinal microbiota are gradually emerging, and various new metabolic modulation drugs are also in clinical development. Therefore, this article reviews the research progress in the treatment of NAFLD in recent years.