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基于病理分级的代谢相关脂肪性肝病严重程度对袖状胃切除术后疗效的影响
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Abstract:
随着肥胖及其合并症的全球大流行,SG手术因其安全有效,操作简单而成为主要的减重手术之一。代谢性脂肪性肝病(MASLD)是与代谢功能障碍相关的慢性肝病,MASLD分为四个等级:无MASLD、轻度、中度和重度脂肪变性。随着全球肥胖和代谢疾病的流行,MASLD的患病率上升,尤其在肥胖和2型糖尿病患者中较为常见。研究表明,袖状胃切除术(SG)对MASLD患者有效,但术后体重减轻效果因病情严重程度而异。重度MASLD患者通常因胰岛素抵抗、肝脏炎症和代谢紊乱,术后体重减轻较慢且效果差。慢性炎症和肝纤维化进一步加剧这一问题。精准的术前评估和个体化治疗策略对优化术后效果至关重要。未来的研究应深入探讨MASLD分级与SG术后疗效的关系,优化治疗方案,提高长期代谢获益。
With the global epidemic of obesity and its complications, SG surgery has become one of the main weight-loss operations because of its safety, effectiveness and simple operation. Metabolic fatty liver disease (MASLD) is a chronic liver disease related to metabolic dysfunction. MASLD is divided into four grades: no MASLD, mild, moderate and severe steatosis. With the prevalence of obesity and metabolic diseases in the world, the prevalence of MASLD is increasing, especially in obese and type 2 diabetic patients. Studies have shown that sleeve gastrectomy (SG) is effective for patients with MASLD, but the effect of weight loss after operation varies with the severity of the disease. Patients with severe MASLD usually lose weight slowly after operation due to insulin resistance, liver inflammation and metabolic disorder, and the effect is poor. Chronic inflammation and liver fibrosis further aggravate this problem. Accurate preoperative evaluation and individualized treatment strategy are very important to optimize postoperative results. Future research should further explore the relationship between MASLD grading and postoperative curative effect of SG, optimize the treatment plan and improve the long-term metabolic benefit.
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