摘要
研究表明,非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者患心房颤动(atrial fibrillation,AF)的风险明显增加,NAFLD可能与AF相关。胰岛素抵抗、糖脂代谢紊乱、炎症、纤维化、自主神经功能紊乱及其复杂的相互关系可能是NAFLD和AF的共同病理过程。未来研究应侧重以下方面:第一,目前无直接证据表明NAFLD是否独立损害心房传导,需要未来的研究能够直接针对NAFLD与心脏电生理特性变化之间的关系加以阐述。第二,现有的研究数据限制了将NAFLD作为AF的直接原因与NAFLD和其他心血管风险因素作为潜在原因进行区分的能力,未来需要严格的基础实验来阐明具体的病理机制以及高质量的干预试验来确定有效的治疗靶点。第三,积极防治NAFLD应该是减少AF发生的重要措施之一,需要未来在防治NAFLD药物临床试验中有意识加入影响AF发生的研究内容,以评估其对患者总体风险的防控。第四,目前关于中医药治疗NAFLD预防AF发生的直接研究还较少,未来有待规范化、标准化、多中心、大样本的临床试验以及基础研究。
Studies have shown that patients with non-alcoholic fatty liver disease(NAFLD)have a significantly increased risk of atrial fibrillation(AF),and NAFLD may be related to AF.Insulin resistance,glucose and lipid metabolism disorder,inflammation,fibrosis,autonomic nerve dysfunction and their complex relationship may be the common pathological process of NAFLD and AF.Future studies should focus on the following aspects:First,there is no direct evidence to show whether NAFLD independently damages atrial conduction,so future studies need to be able to directly elaborate on the relationship between NAFLD and the changes in cardiac electrophysiological characteristics.Second,the existing study data limit the ability to distinguish NAFLD as the direct cause of AF from NAFLD and other cardiovascular risk factors as potential causes.In the future,strict basic experiments are needed to clarify the specific pathological mechanism and high-quality intervention experiments to determine effective treatment targets.Third,active prevention and treatment of NAFLD should be one of the important measures to reduce the occurrence of AF.In the future,it is necessary to consciously add the study content that simultaneously affects the occurrence of AF in the clinical experiments of drugs for the prevention and treatment of NAFLD,so as to evaluate its prevention and control of the overall risk of patients.Fourth,at present,there are few direct studies on the prevention of AF by TCM in the treatment of NAFLD.In the future,multi-center and large-sample clinical experiments and basic studies need to be normalized and standardized.
作者
包鑫鑫
顾宁
BAO Xin-xin;GU Ning(Nanjing University of Chinese Medicine,Jiangsu,China,210029;Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing,Jiangsu,China,210022)
出处
《河南中医》
2022年第3期361-365,共5页
Henan Traditional Chinese Medicine
基金
第二批江苏省中医药领军人才培养项目{苏中医科教【2018】4号}。
关键词
心房颤动
非酒精性脂肪性肝病
心脏重构
研究进展
atrial fibrillation(AF)
non-alcoholic fatty liver disease(NAFLD)
cardiac reconstruction
research progress
