代谢相关脂肪性肝病进展综合防控策略

摘要/Abstract

摘要： 代谢相关脂肪性肝病(MASLD)已成为全球最常见的慢性肝病之一。其疾病负担不仅局限于单纯肝脂肪变性、代谢相关脂肪性肝炎、肝纤维化、肝硬化和肝细胞癌等肝脏事件,还突出表现为心血管疾病、慢性肾脏病及代谢并发症风险增加。2型糖尿病、肥胖、高血压和血脂异常等代谢共病既可促进肝内脂毒性、炎症反应和细胞外基质沉积,又可通过内皮功能障碍、慢性低度炎症和动脉粥样硬化进展放大肝外临床事件风险。目前,心血管事件已成为MASLD患者最主要的死亡原因,而肝纤维化程度则是肝脏相关不良事件和肝脏相关死亡的关键因素。本文围绕MASLD疾病负担、进展因素、临床结局、病理机制及综合管理策略进行系统梳理,强调肝病专科应在多学科协作体系中主动承担风险分层与代谢管理协调职责,建立以生活方式干预为基础、以代谢共病优化管理为核心、以高纤维化风险患者肝脏特异性干预为强化手段的三层递进防控框架,以期改善患者长期整体预后。

徐璐, 芮法娟, 胡新玉, 李婕. 代谢相关脂肪性肝病进展综合防控策略[J]. 肝脏, 2026, 31(6): 778-786.

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