非酒精性脂肪性肝病的无创性诊断方法

肝活组织检查（LB）是评估非酒精性脂肪性肝病（NAFLD）肝脏病理损伤程度的＂金标准＂,但因其有创性,未能广泛应用于临床。近年来非酒精性脂肪性肝炎（NASH）和进展期肝纤维化无创诊断方法研究进展较快,从临床及生物化学指标、生物标志物、影像学技术方面简述了诊断价值较高的部分无创诊断方法。目前认为NAFLD无创诊断方法尚不能取代LB,但联合应用血清细胞角蛋白18片段和NAFLD纤维化评分、瞬时弹性成像可初步诊断NASH及伴或不伴进展期肝纤维化,并进一步确定LB的使用。...

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Bibliographic Details
Published in临床肝胆病杂志 Vol. 29; no. 8; pp. 635 - 638
Main Author 白阳 张霞
Format Journal Article
LanguageChinese
Published 重庆医科大学附属第二医院消化内科,重庆,400010 2013
Subjects
肝硬化
脂肪肝
诊断技术,消化系统
脂肪肝
fatty liver
diagnostic techniques,digestive system
肝硬化
诊断技术,消化系统
liver cirrhosis
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ISSN1001-5256
DOI10.3969/j.issn.1001-5256.2013.08.022

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Summary:肝活组织检查（LB）是评估非酒精性脂肪性肝病（NAFLD）肝脏病理损伤程度的＂金标准＂,但因其有创性,未能广泛应用于临床。近年来非酒精性脂肪性肝炎（NASH）和进展期肝纤维化无创诊断方法研究进展较快,从临床及生物化学指标、生物标志物、影像学技术方面简述了诊断价值较高的部分无创诊断方法。目前认为NAFLD无创诊断方法尚不能取代LB,但联合应用血清细胞角蛋白18片段和NAFLD纤维化评分、瞬时弹性成像可初步诊断NASH及伴或不伴进展期肝纤维化,并进一步确定LB的使用。
Bibliography:fatty liver; liver cirrhosis; diagnostic techniques; digestive system
BAI Yang,ZHANG Xia.（Department of Gastroenterology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China）
Liver biopsy（LB） is considered the gold standard for assessing the pathological damage of the liver in nonalcoholic fatty liver disease（NAFLD）,but this technique is not widely applied in clinical diagnosis because it is invasive.Rapid progress has been made in the research on the methods for noninvasive diagnosis of nonalcoholic steatohepatitis（NASH） and advanced fibrosis in recent years.Some noninvasive methods with relatively high diagnostic values from the aspects of clinical and biochemical indices,biomarkers,and imaging techniques were reviewed.Currently,it is thought that the noninvasive diagnostic methods for NAFLD still cannot be used as a substitute for LB,but a combination of serum cytokeratin 18 fragments,NAFLD fibrosis score,and FibroScan can make for primary diagnosis of NASH with or without ad
ISSN:1001-5256
DOI:10.3969/j.issn.1001-5256.2013.08.022