Başak GÖREN
(Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Dahiliye Kliniği, Ankara, Türkiye)
Turgay FEN
(Onkoloji Eğitim ve Araştırma Hastanesi, Hematoloji Kliniği, Ankara, Türkiye)
Yıl: 2005Cilt: 25Sayı: 6ISSN: 1300-0292 / 2146-9040Sayfa Aralığı: 841 - 850Türkçe

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Non-alkolik yağlı karaciğer hastalığı
Non-alkolik yağlı karaciğer hastalığı, alkol almayan kişilerde alkole bağlı yağlı karaciğer hastalığının histolojik bulgularının olduğu bir karaciğer hastalığıdır. Non-alkolik yağlı karaciğer hastalığı basit steoatozdan steatohepatit, ilerlemiş fibrozis ve siroza kadar geniş spektrumlu bir karaciğer hasarını tanımlar. Non-alkolik yağlı karaciğer hastalığı, çoğunlukla obezite, tip 2 diyabet, hiperlipidemi ve insülin direnci sonucu olarak, gelişmiş ülkelerdeki en sık kronik karaciğer hastalığıdır. Non-alkolik yağlı karaciğer hastalığının klinik önemi toplumda sık görülmesi, siroza ve son dönem karaciğer hastalığına ilerleme potansiyelinden kaynaklanır. Basit steatozun benign klinik gidişi olmasına karşılık, non-alkolik steatohepatit daha çok ilerleyici fibrozis ve siroz riski ile spesifik tanısal özellikleri olan bir alt gruptur. Çift vuruş teorisi basit steatozdan non-alkolik steatohepatit, fibrozis ve siroza ilerleyişi en iyi tanımlar. Bu çift vuruşlar insülin direnci nedeniyle karaciğerde aşırı yağ birikmesi ve reaktif oksijen türleri nedeniyle oksidatif stresin birleşiminden oluşur. Laboratuvar testleri ve görüntüleme çalışmalarının steatozu, steatohepatitten ayırt edememesi karaciğer biyopsisini ve histopatolojik değerlendirmeyi zorunlu kılar. Günümüzde tedavi hiperlipidemi, diabetes mellitus, obezite gibi risk faktörlerini değiştirmeye odaklanmıştır. Olguların çoğunda tedavi 6 ayın üzerinde %10 civarında kilo vermeyi ve bunu sürdürmeyi başarmayı amaçlar. Vitamin E, N-astilsistein gibi antioksidanlar tedavide yararlı olabilirler. Bu makalede, non-alkolik yağlı karaciğer hastalığının günümüzdeki ve potansiyel gelecekteki tedavi stratejileri tartışılmıştır.
Fen > Tıp > Gastroenteroloji ve Hepatoloji
DergiDerlemeErişime Kapalı
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