脂肪肝诊断与治疗PPT课件.ppt

非酒精性脂肪性肝炎
脂肪肝的基本概念
狭义的定义
肝内甘油三酯储积>肝脏湿重的5%,光镜下每单位面积见>30%的肝实质细胞出现脂变,称为脂肪性肝病(fatty liver disease FLD),简称脂肪肝。
根据病情进展的疾病谱分为
单纯性脂肪肝
(nonalcoholic fatty liver NAFL)
脂肪性肝炎
(nonalcoholic steatohepatitis NASH)
脂肪性肝硬化
(Fatty cirrhosis )
脂肪肝分类
根据脂肪变性累及范围
弥漫性脂肪肝(急性和慢性)
局灶性脂肪肝
弥漫性脂肪肝伴正常肝岛。
根据病因
酒精性脂肪肝(alcoholic liver disease ALD)
非酒精性脂肪肝(nonalcoholic fatty liver disease NAFLD)
NAFLD的病因
insulin resistance
glucose intolerance
Diabetes
central obesity
dyslipidaemia
hypertension
However, after exclusion of a history of significant alcohol intake, which is conventionally <20 g/day
NAFLD的病因
nutritional causes:rapid weight loss and total parenteral nutrition
rare metabolic disorders and drug-induced steatosis.
Commonly implicated agents :glucocorticoids, amiodarone, synthetic oestrogens and highly active antiretroviral drugs (HAART)
Steatosis is also frequently associated with hepatitis C, particularly genotype 3, and endocrine disorders such as polycystic ovary syndrome (PCOS),hypopituitarism and hypothyroidism.