代谢功能障碍相关脂肪性肝病非侵入性诊断研究进展  

Advances in non-invasive diagnosis of metabolic dysfunction-associated fatty liver disease

作　　者：王子谦 王士旭 刘艺行 王朝阳 WANG Ziqian;WANG Shixu;LIU Yihang;WANG Chaoyang(Department of General Surgery,Huaihe Hospital of Henan University,Kaifeng 475000,Henan Province,China)

机构地区：[1]河南大学淮河医院普外科,河南开封475000

出　　处：《医学新知》2024年第7期807-816,共10页New Medicine

基　　金：河南省科技攻关项目(202102310105)。

摘　　要：代谢功能障碍相关脂肪性肝病(metabolic dysfunction-associated fatty liver disease,MASLD)按病程阶段主要包括单纯性肝脂肪变性,及在此基础上发展的代谢功能障碍相关性脂肪性肝炎(metabolic dysfunction-associated steatohepatitis,MASH)以及后续的肝纤维化、肝硬化和肝细胞癌(hepatocellular carcinoma,HCC)。MASLD全球患病率近30%,造成了极大的疾病负担,早诊断早治疗至关重要。肝活检仍然是MASLD脂肪变性的金标准,但费用较高,存在内出血、感染等风险,并不适合大规模临床应用。目前随着分子生物学、基因组学和机器学习的进步,越来越多的无创性监测手段应用于临床,且基于无创手段的预测模型取得了很好的临床效果。本文主要从影像学和生物标志物两方面入手,对MASLD无创诊断的相关进展进行综述。Metabolic dysfunction-associated fatty liver disease(MASLD)mainly includes simple hepatic steatosis,and on the basis of this,metabolic dysfunctionassociated steatohepatitis(MASH)and subsequent liver fibrosis,cirrhosis and hepatocellular carcinoma(HCC).The global prevalence of MASLD is nearly 30%,causing a significant disease burden.Early diagnosis and treatment are important.Liver biopsy remains the gold standard for diagnosing hepatic steatosis in MASLD,but it is costly and carries risks such as internal bleeding and infection,making it unsuitable for large-scale clinical application.With advancements in molecular biology,genomics,and machine learning,an increasing number of non-invasive monitoring methods are being applied in clinical practice,and predictive models based on these non-invasive methods have achieved good clinical outcomes.This paper reviews the recent advances in non-invasive MASLD diagnosis,mainly focusing on imaging and biomarkers.

关 键 词：代谢功能障碍相关脂肪性肝病 代谢功能障碍相关性脂肪性肝炎 肝脂肪变性 肝纤维化 血清标志物 诊断 

分 类 号：R575.5[医药卫生—消化系统]