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非酒精性脂肪性肝病患者的感染——现状

infection in patients with nonalcoholic fatty liver disease-current status.

作者信息

Kiseleva Yana V, Maslennikov Roman V, Gadzhiakhmedova Aida N, Zharikova Tatyana S, Kalinin Dmitry V, Zharikov Yury O

机构信息

International School "Medicine of the Future", I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia.

Department of Internal Medicine, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia.

出版信息

World J Hepatol. 2023 Feb 27;15(2):208-215. doi: 10.4254/wjh.v15.i2.208.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, leading to fibrosis, cirrhosis and hepatocellular carcinoma and also associated with increased cardiovascular disease mortality. The pathogenesis of NAFLD is not fully understood, although NAFLD is thought to be a hepatic form of metabolic syndrome. There is an increasing understanding of the role of microbiota disturbances in NAFLD pathogenesis, and as with many other conditions affecting the microbiota, NAFLD may be a novel risk factor for () colonization (CDC) and infection (CDI). CDI is an emerging nosocomial disease, and community-acquired cases of infection are growing, probably due to an increase in CDC rates. The association of NAFLD with CDI has been shown in only 4 studies to date, three of which included less than 1000 patients, although the frequency of NAFLD in these studies was observed in almost 20% of the total patient cohort. These data revealed that NAFLD is a risk factor for CDI development and, moreover, is a risk factor for intestinal complications of CDI. More studies are needed to investigate this association and move forward CDC and CDI screening efforts for this group of patients.

摘要

非酒精性脂肪性肝病(NAFLD)是最常见的慢性肝病,可导致肝纤维化、肝硬化和肝细胞癌,还与心血管疾病死亡率增加相关。尽管NAFLD被认为是代谢综合征的一种肝脏表现形式,但其发病机制尚未完全明确。人们越来越认识到微生物群紊乱在NAFLD发病机制中的作用,与许多其他影响微生物群的疾病一样,NAFLD可能是艰难梭菌定植(CDC)和艰难梭菌感染(CDI)的一个新的危险因素。CDI是一种新发的医院感染性疾病,社区获得性感染病例也在增加,这可能是由于CDC发生率上升所致。迄今为止,仅有4项研究表明NAFLD与CDI有关,其中3项研究纳入的患者不足1000例,尽管在这些研究中,NAFLD在几乎20%的总患者队列中被观察到。这些数据表明,NAFLD是CDI发生的一个危险因素,此外,还是CDI肠道并发症的一个危险因素。需要更多的研究来调查这种关联,并推进针对这组患者的CDC和CDI筛查工作。

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