非酒精性脂肪性肝病诊疗现状.docx

烦天睛甘平 烦天睛甘平 烦天睛甘平 烦天睛甘平 与抗炎保肝药的临床应用 口非酒精性脂肪性肝病简介 口非酒精性脂肪性肝病诊疗现状 口抗炎保肝药在N A F L D综合治疗中的应用 脂肪肝的分类 脂肪性肝病(FLD ) 酒*誰肝病(ALD) 非酒精性脂肪性肝病 (NAFLD ) 非酒精性单纯性脂肪肝非酒精性脂肪性肝炎( 非酒精性单纯性脂肪肝 非酒精性脂肪性肝炎(NASH ) 轻症酒精性肝病酒*誰脂肪肝酒帆肝炎酒*誰肝硬化 NASH相关肝硬化 正常肝脏 NAFLD NAFLD定义和类型 ?:?定义 □ NAFLD是与胰岛素抵抗和遗传易感性密切相关的获得性代谢应 激性肝损伤,其病理学改变与酒精性肝病相似，但患者无过量饮 酒史， □疾病谱包括单纯性脂肪肝、脂肪性肝炎及其相关性肝硬化和肝细 胞癌。 ? NAFLD是21世纪全球重要的公共健康问题之一,亦是我国愈来 愈重要的慢性肝病问题。 NAFLD流行病学 □ NAFLD是欧美等西方发达国家肝功能异常和慢性肝 病最常见的原因 /普通成人NAFLD患病率为20%-33% ,其中NASH和肝硬化分 别占 10%-20% 和 2%-3% /肥胖症患者SFL患病率为60%-90%、NASH为20%-25%、肝 硬化为2%-8% / 2型糖尿病和高脂血症患者NAFLD患病率分别为28%-55%和 27%-92% 中华医学朝狷字分瓮旨肪肝和酒精性肝病字组非酒精性脂肪性肝病诊疗指南(201。年修订版).中华肝脏病杂志卽10,18(3):163-166. 击国人群中代谢综合征和超重的流行率 Prevalence of the metabolic syndrome and overweight among adults in China Lonc?t?OOi5r 365： 1398^5 See Comment Dongfeng Gu. Kristi Reynofds, Xigin Wur Jing Chenr Xiufangf Duanr Robert F Reyinafds, Pau/ K WMtonJicng HeJortfiefuMrAgiA CofMboraciue Group ^embeKlistd^i end of pmpw D*partmen1 -DfEpiH^ii^ilogy^ Tukne Ungrsity Schod of Public Heakh -arnd T ropical Medic ine (K Reynolds Ph% I Che-n M,Dr Prof P K Whdton MR Piof J H世 Mt：% And Department □fJ^edicine, Tulane University School of Medicirw： ij Chen. P KWhdtcnJHe)., New Orleans, LA? USA； Cardiovascular Sum niary Background The metabolic syndrome and obesity are major risk factors for cardiovascular diseaj in formal ion exisls cm I lie prevalence of ihe inelabolic syndrome in Chins. We ainud hi provide 11 estimates of ihc prevalence of the metabolic syndrome and o^emeighl in lhe general adult populalion ii Methods We did a cross-serlioiiLil survey in a nulionally represenlalive sample uf 15 540 Chinese ?dh 35-74 years in 2000-01. Metabolic syndrome was detiiied according 10 guidelines from ihe US (JiuleslcnJ EducaLion Pru^ram. Ovcmrif；lil was d^liiHNd as hculy-niass index of 25 -l kg/m-2or j^rraler. Gu DR et al. Prevalence of the metabolic syndrome and overweight among adults in China [J].Lan 06^2005,365:1398-405. 烦天睛甘平 国MS及超重者的估算总数 -os1c 5ws一-一ErEnu-s一