非酒精性脂肪性肝病患者肝纤维化筛查、评估路径及管理  

Liver fibrosis screening, evaluation pathway, and management in patients with fatty liver

作　　者：徐亮[1] 宓余强[1] Xu Liang;Mi Yuqiang(Department of Hepatology,Center for Fatty Liver,Tianjin Second People’s Hospital,Tianjin Research Institute of Liver Diseases,Tianjin 300192,China)

机构地区：[1]天津市第二人民医院肝病三科与脂肪肝中心,天津市肝病医学研究所,天津300192

出　　处：《中华肝脏病杂志》2023年第8期798-804,共7页Chinese Journal of Hepatology

基　　金：天津市卫生健康科技项目重点学科专项(TJWJ2022XK034);天津市医学重点学科(专科)建设项目(TJYXZDXK-059B);天津市卫生和计划生育委员会中西医结合科研课题重点项目(2021022)。

摘　　要：非酒精性脂肪性肝病(NAFLD)并非良性疾病,尤其是非酒精性脂肪性肝炎(NASH)合并肝纤维化F2~4患者发生肝脏相关事件和死亡的风险较高,因此,被认为是"有风险"的NASH。我国NAFLD患者群体庞大,如何筛查出存在肝纤维化人群是一个重要社会经济学问题。目前,肝纤维化的无创诊断方法(NITs)有血清学模型、基于振动控制瞬时弹性成像及磁共振弹性成像的肝硬度检测,现结合近年来NITs的研究进展及NAFLD国内外防治指南,梳理了NAFLD患者肝纤维化筛查、评估路径及管理建议。Non-alcoholic fatty liver disease(NAFLD)is not a benign condition,especially in patients with non-alcoholic steatohepatitis(NASH)combined with liver fibrosis grades F2-4,who have a higher risk of liver-related events and mortality.Thus,this population is considered"at-risk"for developing NASH.China has a large NAFLD patient population,so how to screen for those with liver fibrosis is an important socio-economic concern.At the moment,serological models,liver stiffness detection based on vibration-controlled transient elastography,and magnetic resonance elastography(MRE)are the only non-invasive tests(NITs)for liver fibrosis.The prevention and treatment guidelines for NAFLD at home and abroad are reviewed here,based on the research progress of NITs in recent years,so as to suggest screening,evaluation pathways,and management for liver fibrosis in patients with NAFLD.

关 键 词：脂肪肝 纤维化 无创 路径 管理 

分 类 号：R575.5[医药卫生—消化系统]