NASH・NAFLDの診療ガイド　2021

出版社： 文光堂
著者：
発行日： 2021-03-16
分野： 臨床医学：内科  >  肝/胆/膵
ISBN： 9784830621109
電子書籍版： 2021-03-16 （第1版第2刷）
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本書全体を定義，疫学，病因・病態，検査所見，病理所見，治療，予後の全7章に分け，図表を多用し診療に役立つ最新情報を記載．また前版に引き続き，病理所見はアトラス形式を用いてわかりやすく提示．さらに，最新の診療ガイドラインに準拠するとともに，その一歩先を行く内容を盛り込むことで，NASH・NAFLD診療の現状とスタンダードを指し示した．本疾患に携わる多くの方々に手にとっていただきたい一冊．

目次

  • 第1章　NAFLDの定義と分類
    　1．非アルコール性脂肪性肝疾患NAFLDとは
    　2．疾患概念の変遷と臨床現場での認識の変化
    　3．NAFLDの定義（診療ガイドラインに準拠した定義）

    第2章　NAFLDの疫学
    　1．NASH・NAFLDの有病率
    　　1　有病率と性別・年齢・地域との関連
    　　2　有病率とBMIとの関連
    　　3　線維化への進展
    　2．NAFLDにおける生活習慣病の頻度
    　3．非肥満患者におけるNASH・NAFLDの有病率
    　［memo］アジア人における非肥満NAFLD
    　4．小児におけるNASH・NAFLDの有病率
    　［memo］B, C型慢性肝炎治療後の脂肪肝

    第3章　NAFLDの病因・病態
    　1．NAFLDの基本的病因・病態
    　　1　肥満
    　［memo］メタボリックシンドローム
    　［memo］アディポサイトカイン
    　　2　インスリン抵抗性
    　2．NAFLDの発症機序
    　　1　遺伝的素因
    　　　1）PNPLA3 遺伝子
    　　　2）NAFLD病態に関与するその他の遺伝子多型
    　　　　a．TM6SF2
    　　　　b．CKR
    　　　　c．MBOAT7
    　　　　d．DYSF
    　　　　e．PEMT
    　　2　脂肪肝形成にかかわる脂質代謝
    　　　1）脂肪酸およびTG合成系
    　［memo］adenosine monophosphate（AMP）activated protein kinase（AMPK）
    　　　2）肝細胞での脂肪酸酸化
    　　　3）肝細胞からのTGの血中放出
    　3．脂肪肝に伴う肝細胞傷害の機序
    　　1　酸化ストレス
    　［memo］活性酸素種（ROS）とROS消去系
    　　　1）ミトコンドリアの異常
    　　　2）ミクロソームおよびペルオキシソームの関与
    　　2　脂肪毒性
    　　3　腸内細菌叢の変化と自然免疫系
    　　4　NAFLD病態形成に関与するその他の要因

    第4章　NAFLDの検査所見
    　1．肝脂肪化診断に有用な画像検査
    　　1　腹部エコー検査
    　　2　VCTE
    　　3　MR spectroscopy（MRS）
    　2．肝線維化診断に有用な血液学的バイオマーカーおよびスコアリングシステム
    　　1　肝線維化マーカー
    　　2　スコアリングシステム
    　3．肝線維化診断に有用な画像検査
    　4．肝生検の適応症例
    　5．肥満・2型糖尿病患者におけるスクリーニング

    第5章　NAFLDの病理所見
    　1．はじめに
    　2．病理所見
    　　1　ballooningの評価
    　　2　マロリー・デンク体の評価
    　　3　脂肪化の評価
    　　4　線維化の評価
    　3．所見の記載と総合評価
    　4．参考資料
    　5．まとめ

    第6章　NAFLDの治療
    　1．はじめに
    　2．NAFLDの治療方針
    　3．食事療法・運動療法
    　4．薬物療法
    　　1　糖尿病治療薬
    　　　1）チアゾリジン薬
    　　　2）SGLT2阻害薬
    　　　3）GLP-1 受容体作動薬
    　　　4）ビグアナイド薬（メトホルミン）
    　　2　脂質異常症治療薬
    　　　1）スタチン系薬剤（HMG-CoA還元酵素阻害薬）
    　　　2）フィブラート系薬剤
    　　　3）エゼチミブ
    　　3　降圧薬
    　　　1）アンジオテンシンII受容体拮抗薬（ARB），ACE阻害薬
    　　4　抗酸化療法
    　　　1）ビタミンE
    　　　2）ペントキシフィリン
    　　　3）ベタイン
    　　　4）瀉血療法
    　　5　肝臓用薬
    　　　1）ウルソデオキシコール酸
    　　　2）強力ネオミノファーゲンシー
    　　6　現在開発中の薬剤
    　5．外科療法
    　　1　腹腔鏡下スリーブ状胃切除術，腹腔鏡下胃バイパス術
    　　2　肝移植

    第7章　NAFLDの予後
    　1．はじめに
    　2．NAFLDの予後
    　3．NAFLの予後
    　4．NASHの予後
    　5．NASH肝硬変
    　6．NASH肝細胞癌の特徴

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

第1章 NAFLDの定義と分類

P.5 掲載の参考文献
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第2章 NAFLDの疫学

P.12 掲載の参考文献
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第3章 NAFLDの病因・病態

P.24 掲載の参考文献
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第4章 NAFLDの検査所見

P.30 掲載の参考文献
1) Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease : Practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2018 ; 67 : 328-357.
 
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4) 日本肝臓学会 (編). NASH・NAFLDの診療ガイド 2015, 文光堂, 2015.
 
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第5章 NAFLDの病理所見

P.40 掲載の参考文献
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第6章 NAFLDの治療

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第7章 NAFLDの予後

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