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非酒精性脂肪肝(NAFL)病理学上和酒精性脂肪肝相似,但无饮酒史;临床上可以发展至终末期肝病的一种疾病。但相当一部分病人病情较轻且较稳定。引起NAFL的病因很多,大致可分为营养性、代谢性、内分泌性、药物性、外科手术和其它原因,而肥胖、高脂血症和糖尿病已成为NAFL的最主要原因。NAFL的发病机制尚不十分清楚,因此,需进行综合治疗。但治疗的关键在于控制肥胖、高脂血症、糖尿病及停用相关肝毒性药物。现综述近年NAFL的治疗进展,以资临床参考。 1 脂肪肝相关疾病的治疗国内外研究结果均认为肥胖是脂肪肝的最重要原因之一。肥胖者中至少有半数患脂肪肝,肥胖和脂肪肝有很强的正相关。当肥胖得到控制后,肝脏中沉积的脂肪可以消退。Ueno等研究证实,通过3个月的膳食和体育锻炼控制体重后,血液生化指标(转氨酶、总胆固醇、空腹血糖)及肝组织学均有改善。Eriksson等对超
Non-alcoholic fatty liver disease (NAFL) pathologically similar to alcoholic fatty liver, but no history of alcohol consumption; clinically advanced to end-stage liver disease can be a disease. However, a considerable number of patients are less severe and more stable. The causes of NAFL are many and can be broadly divided into nutritional, metabolic, endocrine, medicinal, surgical and other causes, and obesity, hyperlipidemia and diabetes have become the leading causes of NAFL. The pathogenesis of NAFL is not yet clear, therefore, the need for comprehensive treatment. But the key is to control the treatment of obesity, hyperlipidemia, diabetes and disable relevant hepatotoxic drugs. Now summarize the progress of NAFL treatment in recent years, with funding for clinical reference. 1 treatment of fatty liver-related diseases Domestic and foreign studies have concluded that obesity is one of the most important causes of fatty liver. At least half of obese patients have fatty liver, and there is a strong positive correlation between obesity and fatty liver. When obesity is under control, fat deposited in the liver can subside. Ueno and other studies confirmed that after 3 months of diet and physical exercise to control body weight, blood biochemical indicators (aminotransferase, total cholesterol, fasting blood glucose) and liver histology improved. Eriksson et al