脂肪性肝病诊疗规范化的专家建议(2019年修订版)  

Expert recommendations on standardized diagnosis and treatment for fatty liver disease (2019 revised edition)

作　　者：无 施军平[5] 范建高[6] 无;Fan Jiangao;Shi Junping(Committee of Hepatology,Chinese Research Hospital Association;Fatty Liver Expert Committee,Chinese Medical Doctor Association;National Workshop on Fatty Liver and Alcoholic Liver Disease,Chinese Society of Hepatology;National Workshop on Liver and Metabolism,Chinese Society of Endocrinology,Chinese Medical Association;Department of Gastroenterology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Liver Diseases,The Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]中国研究型医院学会肝病专业委员会 [2]中国医师协会脂肪性肝病专家委员会 [3]中华医学会肝病学分会脂肪肝与酒精性肝病学组 [4]中华医学会内分泌学分会肝病与代谢学组 [5]杭州师范大学附属医院肝病科,杭州310015 [6]上海交通大学医学院附属新华医院消化内科,上海200092

出　　处：《实用肝脏病杂志》2019年第6期787-792,共6页Journal of Practical Hepatology

摘　　要：非酒精性脂肪性肝病(NAFLD)已成为我国最常见的慢性肝病。本建议从以下5个方面对NAFLD的规范化诊断和治疗进行了修订:(1)诊治中心/专病门诊的组织架构及功能;(2)筛查和评估:包括筛查对象、初步评估、病因筛查、非酒精性脂肪性肝炎(NASH)和进展性肝纤维化的无创诊断、肝活组织病理学检查以及代谢紊乱和心血管风险评估等;(3)临床处理:包括生活方式(饮食运动减重)调整,合并糖脂代谢紊乱、高血压等特殊人群的处理以及脂肪性肝炎和肝纤维化的药物选择;(4)特殊人群的管理:儿童、妊娠和哺乳期妇女、合并酒精性肝病、慢性HBV和/或HCV感染以及合并自身免疫现象等;(5)监测与随访。本建议旨在优化NAFLD患者的管理流程,指导临床医生制定更为合理的诊疗决策。Nonalcoholic fatty liver disease(NAFLD)is the most common liver disease in China.To provide evidence-based and updated practical recommendations for clinician,this expert recommendations have updated the diagnosis and treatment of NAFLD in five aspects as follows:(1)the framework of NAFLD treatment centre or clinic;(2)screening and evaluation:who should be screened,initial evaluation items,non-invasive assessment of steatohepatitis and advanced fibrosis,when to obtain a liver biopsy in patients with NAFLD,and other metabolic disorders and cardiovascular risk assessment;(3)managements of patient with NAFLD:lifestyle intervention(dietary,exercise and weight loss),drug treating metabolic co-morbidities such as hyperlipidemia,type 2 diabetes mellitus and hypertension,and steatohepatitis and fibrosis;(4)management of special populations with NAFLD:children,pregnant or lactating women,patients co-existence with alcoholic liver disease,chronic HBV and/or HCV infection,and autoimmune disorders;(5)monitoring and follow-up.This consensus aims to modify the optimizing management process and guide physicians make correct and reasonable decisions in the diagnosis and treatment for patients with NAFLD.

关 键 词：脂肪肝 代谢综合征 酒精中毒 诊断 治疗 共识 

分 类 号：R57[医药卫生—消化系统]