|
|
肝硬化患者营养不良的研究进展
|
Abstract:
营养不良是肝硬化的常见且严重的并发症，与不良预后相关。因此需要及时的筛查、评估和治疗以改善预后。本综述就肝硬化营养不良发生机制、风险筛查工具、评估及治疗方面的进展进行阐述，旨在提高临床医务人员对肝硬化营养不良的认识及对其治疗研究提供参考。
Malnutrition is a common and serious complication of cirrhosis and is associated with poor prog-nosis. Therefore, timely screening, assessment and treatment are needed to improve the prognosis. This article reviews the progress in pathogenesis, risk screening tools, assessment and treatment of cirrhotic malnutrition in order to improve the understanding of clinical staff and provide reference for the treatment of cirrhotic malnutrition.
| [1] | 肝硬化诊治指南[J]. 实用肝脏病杂志, 2019(5): 624-635. |
| [2] | Huisman, E.J., Trip, E.J., Siersema, P.D., van Hoek, B. and van Erpecum, K.J. (2011) Protein Energy Malnutrition Predicts Complications in Liver Cirrhosis. European Journal of Gastroenterology & Hepatology, 23, 982-989.
https://doi.org/10.1097/MEG.0b013e32834aa4bb |
| [3] | 侯维, 蒋朱明, 杨剑, 许静涌. 慢性肝病患者肠外肠内营养支持与膳食干预专家共识[J]. 临床肝胆病杂志, 2017, 33(7): 1236-1245. |
| [4] | Chapman, B., Sinclair, M., Gow, P.J. and Testro, A.G. (2020) Malnutrition in Cirrhosis: More Food for Thought. World Journal of Hepatology, 12, 883-896. https://doi.org/10.4254/wjh.v12.i11.883 |
| [5] | Grüngreiff, K., Reinhold, D. and Wedemeyer, H. (2016) The Role of Zinc in Liver Cirrhosis. Annals of Hepatology, 15, 7-16. https://doi.org/10.5604/16652681.1184191 |
| [6] | Haberl, J., Zollner, G., Fickert, P. and Stadlbauer, V. (2018) To Salt or Not to Salt?—That Is the Question in Cirrhosis. Liver International, 38, 1148-1159. https://doi.org/10.1111/liv.13750 |
| [7] | Bauer, T.M., et al. (2001) Small Intestinal Bacterial Overgrowth in Patients with Cirrhosis: Prevalence and Relation with Spontaneous Bacterial Peritonitis. American Journal of Gastroenterology, 96, 2962-2967. |
| [8] | Levitt, D.G. and Levitt, M.D. (2017) Protein Losing Enteropathy: Comprehensive Review of the Mechanistic Association with Clinical and Subclinical Disease States. Clinical and Experimental Gastroenterology, 10, 147-168.
https://doi.org/10.2147/CEG.S136803 |
| [9] | Puri, P., et al. (2021) Nutrition in Chronic Liver Disease: Consensus Statement of the Indian National Association for Study of the Liver. Journal of Clinical and Experimental Hepatology, 11, 97-143.
https://doi.org/10.1016/j.jceh.2020.09.003 |
| [10] | Plauth, M., et al. (2004) Weight Gain after Transjugular Intrahepatic Portosystemic Shunt Is Associated with Improvement in Body Composition in Malnourished Patients with Cirrhosis and Hypermetabolism. Journal of Hepatology, 40, 228-233. https://doi.org/10.1016/j.jhep.2003.10.011 |
| [11] | Calmet, F., Martin, P. and Pearlman, M. (2019) Nutrition in Patients with Cirrhosis. Gastroenterology & Hepatology, 15, 248-254. |
| [12] | White, J.V., et al. (2012) Consensus Statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition). Journal of Parenteral and Enteral Nutrition, 36, 275-283.
https://doi.org/10.1177/0148607112440285 |
| [13] | McFarlane, M., et al. (2018) Comparing Assessment Tools for Detecting Undernutrition in Patients with Liver Cirrhosis. Clinical Nutrition ESPEN, 23, 156-161. https://doi.org/10.1016/j.clnesp.2017.10.009 |
| [14] | Borhofen, S.M., et al. (2016) The Royal Free Hospi-tal-Nutritional Prioritizing Tool Is an Independent Predictor of Deterioration of Liver Function and Survival in Cirrhosis. Digestive Diseases and Sciences, 61, 1735-1743.
https://doi.org/10.1007/s10620-015-4015-z |
| [15] | Wu, Y., et al. (2020) Royal Free Hospital-Nutritional Prioritizing Tool Improves the Prediction of Malnutrition Risk Outcomes in Liver Cirrhosis Patients Compared with Nutritional Risk Screening 2002. British Journal of Nutrition, 124, 1293-1302. https://doi.org/10.1017/S0007114520002366 |
| [16] | Xu, Y., et al. (2021) Prognostic Value of Inflammatory and Nutritional Markers for Hepatocellular Carcinoma. Medicine, 100, e26506. https://doi.org/10.1097/MD.0000000000026506 |
| [17] | 王笑影, 敬丽桦, 辛辰, 李响, 陈宇, 王忠琼. 小野寺预后营养指数在肝硬化患者营养风险筛查中的应用价值[J]. 实用医院临床杂志, 2021, 18(5): 144-147. |
| [18] | Ahluwalia, N., Dwyer, J., Terry, A., Moshfegh, A. and Johnson, C. (2016) Update on NHANES Die-tary Data: Focus on Collection, Release, Analytical Considerations, and Uses to Inform Public Policy. Advances in Nutrition, 7, 121-134. https://doi.org/10.3945/an.115.009258 |
| [19] | 段钟平, 杨云生, 终末期肝病临床营养指南[J]. 实用肝脏病杂志, 2019, 22(5): 624-635. |
| [20] | Evans, D.C., et al. (2021) The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper. Nutrition in Clinical Practice, 36, 22-28. https://doi.org/10.1002/ncp.10588 |
| [21] | Abbasi, A., Bhutto, A.R., Butt, N., Lal, K. and Munir, S.M. (2012) Serum Cholesterol: Could It Be a Sixth Parameter of Child-Pugh Scoring System in Cirrhotics Due to Viral Hepatitis? Journal of the College of Physicians and Surgeons Pakistan, 22, 484-487. |
| [22] | Privitera, G., Spadaro, L., Marchisello, S., Fede, G. and Purrello, F. (2018) Abnormalities of Lipoprotein Levels in Liver Cirrhosis: Clinical Relevance. Digestive Diseases and Sciences, 63, 16-26.
https://doi.org/10.1007/s10620-017-4862-x |
| [23] | van Dronkelaar, C., et al. (2018) Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review. Journal of the American Medical Directors Association, 19, 6-11.
https://doi.org/10.1016/j.jamda.2017.05.026 |
| [24] | Nishikawa, H., et al. (2019) Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases. Journal of Clinical Medicine, 8, Article No. 336. https://doi.org/10.3390/jcm8030336 |
| [25] | Tandon, P., et al. (2012) Severe Muscle Depletion in Patients on the Liver Transplant Wait List: Its Prevalence and Independent Prognostic Value. Liver Transplantation, 18, 1209-1216. https://doi.org/10.1002/lt.23495 |
| [26] | Reber, E., Gomes, F., Vasiloglou, M.F., Schuetz, P. and Stanga, Z. (2019) Nutritional Risk Screening and Assessment. Journal of Clinical Medicine, 8, Article No. 1065. https://doi.org/10.3390/jcm8071065 |
| [27] | Tantai, X., et al. (2022) Effect of Sarcopenia on Survival in Patients with Cirrhosis: A Meta-Analysis. Journal of Hepatology, 76, 588-599. https://doi.org/10.1016/j.jhep.2021.11.006 |
| [28] | Palmer, L.B., Kuftinec, G., Pearlman, M. and Green, C.H. (2019) Nutrition in Cirrhosis. Current Gastroenterology Reports, 21, Article No. 38. https://doi.org/10.1007/s11894-019-0706-5 |
| [29] | European Association for the Study of the Liver (2019) EASL Clinical Practice Guidelines on Nutrition in Chronic Liver Disease. Journal of Hepatology, 70, 172-193. https://doi.org/10.1016/j.jhep.2018.06.024 |
| [30] | Berzigotti, A., et al. (2017) Effects of an Intensive Lifestyle In-tervention Program on Portal Hypertension in Patients with Cirrhosis and Obesity: The Sportdiet Study. Hepatology, 65, 1293-1305. https://doi.org/10.1002/hep.28992 |
