慢性肝病与缺氧  

Relationship between chronic liver disease and liver hypoxia

作　　者：冯瑞兵[1] 

机构地区：[1]河北医科大学附属人民医院(石家庄市第一医院)消化二科,河北省石家庄市050011

出　　处：《世界华人消化杂志》2016年第14期2184-2190,共7页World Chinese Journal of Digestology

摘　　要：肝脏代谢需要充足的氧气供应,因此肝脏对缺氧损害极为敏感.慢性肝损伤均伴有缺氧;缺氧反过来又加重肝损伤,抑制肝细胞再生,促进肝纤维化、肝硬化乃至肝癌的发生;他们互为因果,互相促进,是各种慢性肝病发展的重要机制.作为体内最重要的缺氧信号传递因子,缺氧诱导因子-1?(hypoxia inducible factor-1?,HIF-1?)参与肝脏许多缺氧适应性调节活动.随着对慢性肝病与缺氧相互关系的不断认识,肝纤维化时针对HIF-1?及其下游靶位的治疗已取得一些进展;一些药物通过改善肝脏微循环,部分纠正肝脏缺氧,对慢性肝病具有积极的治疗作用.但慢性肝病与缺氧之间涉及到复杂的信号通路,其确切调控机制仍需要大量研究工作去进一步阐明.The liver is an organ that metabolizes various substances very vigorously.During hepatic metabolism a large amount of oxygen needs to be provided for the liver,so the liver is vulnerable to hypoxia.Many chronic liver diseases are accompanied by liver cell hypoxia.In turn,liver cell hypoxia not only worsens liver tissue damage on the basis of primary liver lesion and inhibits hepatocellular regeneration but also accelerates liver fibrosis,cirrhosis,and even primary liver carcinoma.With chronic liver diseases exacerbating,liver hypoxia becomes more and more serious,and vice versa.This is an important mechanism by which chronic liver diseases gradually get worse and worse.As the most important hypoxia signal transduction factor in vivo,hypoxia inducible factor-1α（HIF-1α） plays an indispensable key role in the process of adaptive responses of the liver to hypoxia stimulus.Some progress in therapy for chronic liver diseases has been being made as the relationship between chronic liver diseases and liver hypoxia has been revealed and understood more deeply,especially by regulating and controlling HIF-la and its downstream target to treat liver fibrosis.In addition,it has been found that some medicines have positive therapeutic effects on patients with chronic liver diseases through improving liver microcirculation and ameliorating liver hypoxia.However,the very complicated mechanism of interaction between chronic liver diseases and liver hypoxia,which involves a number of complex signal pathways,has not been completely elucidated,and therefore more basic and clinical studies need to be carried out for the clarification of their interaction.

关 键 词：慢性肝病 缺氧 缺氧诱导因子-1Α 血管增生 肝星状细胞 肝纤维化 肝脏微循环 

分 类 号：R575[医药卫生—消化系统]