肠道菌群影响非酒精性脂肪性肝病的机制及应对策略

非酒精性脂肪性肝病(nonalcoholic fatty liver disease，NAFLD)的发病率逐年升高，已成为最常见的肝脏疾病之一。目前其发病机制未被完全阐明，尚无有效治疗药物。肠道菌群与人体共生，作为人体的“第二基因组”，其在消化、吸收及代谢中发挥重要作用。新近研究表明，肠道菌群已成为影响NAFLD发生、进展的重要因素，肠道菌群失调和肠肝轴紊乱与非酒精性单纯性脂肪肝(nonalcoholic fatty liver，NAFL)发展为非酒精性脂肪性肝炎(nonalcoholic steatohepatitis，NASH)、肝纤维化和肝细胞癌(hepatocellular carcinoma，HCC)密切相关。因此，肠道微生态干预有望成为预防或治疗NAFLD的新手段。本综述主要探讨肠道菌群异常对NAFLD/NASH发病过程、机制的影响及干预措施。

The mechanism of intestinal dysbiosis affecting nonalcoholic fatty liver disease and its intervention strategies

Incidence of nonalcoholic fatty liver disease (NAFLD) has been increasing, and NAFLD has become one of the most common liver diseases. Its pathogenesis has not been fully elucidated, and there are no effective medications so far. As the ‘second genome’ of human body, gut microbiota plays an important role in nutrient digestion, absorption and metabolism. Growing evidence has suggested that gut dysbiosis contributes significantly to occurrence of NAFLD and is critical for progression of nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH), liver fibrosis or hepatocellular carcinoma (HCC). Therefore, new strategies for gut microbiota intervention are developed to prevent or treat NAFLD. This review intends to mainly discuss the impacts of intestinal microbial abnormality on the pathogenesis, mechanism and intervention of NAFLD/NASH.