慢性HBV感染重叠非酒精性脂肪性肝病的自然史、无创诊断及临床管理  

Natural history and non-invasive diagnosis and clinical management of chronic HBV infection overlapping with nonalcoholic fatty liver disease

作　　者：徐亮[1] 李萍[1] 陈林 宓余强[1] XU Liang;LI Ping;CHEN Lin;FU Yuqiang(Tianjin Hepatopathy Research Institute,Tianjin Second People’s Hospital,Tianjin 300192,China;Clinical College,The Second People’s Hospital of Tianjin Medical University,Tianjin 300192,China)

机构地区：[1]天津市第二人民医院天津市肝病医学研究所,天津300192 [2]天津医科大学第二人民医院临床学院,天津300192

出　　处：《临床肝胆病杂志》2021年第7期1501-1507,共7页Journal of Clinical Hepatology

摘　　要：慢性HBV感染(CBI)重叠NAFLD情况日益普遍,而在重叠NAFLD对肝病自然史影响的研究中,多数认为重叠NAFLD促进了CBI患者肝硬化、肝细胞癌的发生,并促进了包括肝病死亡在内的全因死亡率,但也有研究得出了不同的结论;CBI重叠NAFLD时发生肝损伤的病因诊断是一个难题,金标准仍是肝组织病理,而探讨无创诊断方法意义重大;CBI重叠NAFLD需要在积极防治NAFLD的基础上根据现行CBI诊疗指南酌情进行抗HBV感染治疗。Chronic HBV infection(CBI)overlapping with nonalcoholic fatty liver disease(NAFLD)is becoming more and more common.Most studies about the influence of overlapping with NAFLD on the natural history of CBI have shown that overlapping with NAFLD promotes not only the development of cirrhosis and hepatocellular carcinoma,but also all-cause mortality including death due to liver disease;however,some studies have reported different outcomes.The etiological diagnosis of liver injury in patients with CBI overlapping with NAFLD is a difficult issue in clinical practice,and liver histopathology is still the gold standard,while it is very important to explore noninvasive diagnostic methods.For patients with CBI overlapping with NAFLD,anti-HBV therapy should be given according to current diagnosis and treatment guidelines for CBI in addition to active prevention and treatment of NAFLD.

关 键 词：乙型肝炎病毒 乙型肝炎 慢性 非酒精性脂肪性肝病 诊断 治疗学 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]