肝硬化患者营养不良、肌肉减少症及骨质疏松的防治  

Prevention and treatment of malnutrition,sarcopenia,and osteoporosis in patients with liver cirrhosis

作　　者：肖慧娟 韩涛[1,3,4,5,6] XIAO Huijuan;HAN Tao(The Third Central Clinical College of Tianjin Medical University,Tianjin 300170,China;Department of Nutrition,Tianjin Third Central Hospital,Tianjin 300170,China;Department of Hepatology,Tianjin Third Central Hospital,Tianjin 300170,China;Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Tianjin 300170,China;Artificial Cell Engineering Technology Research Center,Tianjin 300170,China;Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China)

机构地区：[1]天津医科大学三中心临床学院,天津300170 [2]天津市第三中心医院营养科,天津300170 [3]天津市第三中心医院肝内科,天津300170 [4]天津市重症疾病体外生命支持重点实验室,天津300170 [5]天津市人工细胞工程技术研究中心,天津300170 [6]天津市肝胆疾病研究所,天津300170

出　　处：《临床肝胆病杂志》2021年第1期26-30,共5页Journal of Clinical Hepatology

基　　金：国家十三五科技重大专项(2017ZX10203201-007)。

摘　　要：营养不良、肌肉减少症(肌少症)及骨质疏松是肝硬化患者常见的营养相关并发症,肌少症是营养不良的重要表现,而营养不良、肌少症又是骨质疏松发生的危险因素,三者相互关系密切,且都对肝硬化患者的临床结局和预后产生不良影响,故要及早发现,积极防治。营养物质摄入不足、代谢紊乱、激素水平异常、身体活动缺乏等促使肝硬化患者易出现营养不良、肌少症及骨质疏松。此外,肝病治疗常用药物如糖皮质激素、某些抗病毒药物等可能影响骨代谢,需引起临床关注。合理的营养干预、适当的运动和基础疾病的治疗是防治营养不良、肌少症及骨质疏松的基础。一些针对性治疗药物可有助于改善患者的上述营养相关并发症,但仍需进一步研究证实。Malnutrition,sarcopenia,and osteoporosis are common nutrition-related complications in patients with liver cirrhosis.Sarcopenia is an important manifestation of malnutrition,while malnutrition and sarcopenia are risk factors for osteoporosis.There is a close relationship among them,and they all have adverse effects on the clinical outcomes and prognosis of patients with liver cirrhosis.Therefore,it is necessary to identify them as early as possible and take active measures for prevention and treatment.Insufficient intake of nutrients,metabolic disorders,abnormal hormone levels,and lack of physical activity all contribute to the development of malnutrition,sarcopenia,and osteoporosis in patients with liver cirrhosis.In addition,medications commonly used in the treatment of liver diseases,such as glucocorticoids and some antiviral drugs,may have potential impact on bone metabolism,which needs to be taken seriously in clinical practice.Reasonable nutritional intervention,appropriate exercise,and treatment of underlying diseases are the basis of the prevention and treatment of malnutrition,sarcopenia,and osteoporosis.Some targeted drugs can improve these nutrition-related complications,which needs to be confirmed by further studies.

关 键 词：肝硬化 营养不良 肌肉减少症 骨质疏松 

分 类 号：R575.2[医药卫生—消化系统]