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防疫少動婦人脂肪肝炎  3招遠離脂肪肝醫師這麼說

2022-08-16 記者陳宜琳/嘉義報導

嘉義醫院副院長陳詩典表示，脂肪肝沒有症狀很難察覺，但可能因此轉變成肝炎、肝纖維化甚至肝癌（圖：嘉義醫院提供）

嘉義一名林姓婦人，今年因疫情因素減少外出更大幅降低運動頻次，原先患有慢性疾病也無回診，造成體重及血糖數值皆上升。疫情趨緩之際檢查發現林姓婦人肝功能出現警訊，已罹患脂肪肝炎，所幸經醫師用藥治療且配合調整飲食熱量，肝功能已恢復正常。

嘉義醫院肝膽腸胃科陳詩典副院長表示，常見造成脂肪肝的原因，包括肥胖、高血壓、高血脂、糖尿病控制不佳等，由於脂肪肝沒有症狀，難以察覺，更可能由脂肪肝轉變成肝炎，再形成肝纖維化，最終形成肝硬化甚至肝癌，建議一定要定期健康檢查及早發現病灶。

藥劑科張其純主任說，目前並沒有主要適應症為治療脂肪肝之藥物，大部分採輔助治療。大致可分為三個類別：第一類為Vitamin E(每日服用800IU)及降低胰島素阻抗性藥物（如：Pioglitazone），可改善脂肪肝症狀；第二類較常用來治療血脂異常，亦可部份輔助控制脂肪肝，降血脂藥物（如：statin類)及魚油；第三類為針對脂肪肝可能有效，包含GLP-1致效劑及SGLT-2抑制劑，主要用來治療糖尿病，前者更有減重的效益。減重及飲食控制還是最佳療法，如需使用藥物，還是建議找專科醫師討論治療方向為佳。

營養科林資淳主任也說到，脂肪肝患者飲食建議「高纖、高鈣、抗氧化」為原則，而地中海飲食 (Mediterranean diet)定義為「食用大量蔬菜水果、使用橄欖油為主要脂肪來源、天然乳製品加上適量的魚、蛋及家禽類，少量紅肉及紅酒」。因富含足夠的抗氧化劑、膳食纖維、不飽和脂肪酸，攝取較低比例的飽和脂肪與動物蛋白，因此相當適合脂肪肝患者將地中海飲食取代以往高脂低纖的飲食習慣。

陳詩典副院長提醒民眾，「肥胖是所有疾病的源頭！」，只要體重超標，血壓、血脂、糖尿病都會陸續發生，也可能會造成心血管負擔！遠離脂肪肝應該遵循三步驟，養成固定的運動習慣、減重及飲食控制、定期健康檢查，您就能找回健康。

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