肝硬化患者肌肉减少症的新药研究进展

摘要/Abstract

摘要： 近40%的肝硬化患者患有肌肉减少症(简称“肌少症”)。肌少症的发生将增加肝硬化患者的总体死亡率、降低患者的生活质量。有效治疗肌少症可能改善肝硬化患者的临床结局和生活质量。然而,目前针对肝硬化患者肌少症的药物研究仍处于早期阶段。Ⅱ期临床试验显示,口服LPCN 1148(雄激素受体激动剂)可明显改善等待肝移植的肝硬化男性患者的肌少症并降低患者肝性脑病的发生率,然而Ⅱ期临床试验样本量小且随访周期短,LPCN 1148的长期疗效与安全性,尤其是对肝细胞癌发生率的影响,需要大样本、前瞻性研究进一步论证。目前针对睾酮、L-鸟氨酸L-天冬氨酸、左旋肉碱、β-羟基-β-甲基丁酸、支链氨基酸、维生素D与益生菌在肝硬化患者肌少症治疗中的疗效研究均为小样本、回顾性或单中心研究,证据级别较低,需要开展大样本、前瞻性、多中心研究以确认这些药物在肝硬化患者肌少症治疗中的疗效和安全性。当前关于肝硬化患者肌少症的临床研究多为单一药物或单一疗法,探索联合疗法可能是一个值得关注的方向,将药物与非药物干预相结合或联合不同靶点的药物可能取得更为显著的效果。

关键词: 肝硬化, 肌肉减少症, 新兴药物, 治疗策略

李强, 陈良. 肝硬化患者肌肉减少症的新药研究进展[J]. 肝脏, 2025, 30(9): 1183-1185.

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