非酒精性脂肪性肝病诊治进展

Advances in Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease

近年来随着人们生活水平的提高和生活方式的改变,我国非酒精性脂肪性肝病(NAFLD)的发病率明显上升,现已成为我国常见的慢性肝病之一,且有发展为肝纤维化、肝硬化的可能。超声检查是诊断NAFLD最常用的方法,但特异性不高,且不能明确非酒精性脂肪性肝炎(NASH)和肝纤维化的程度。肝活检是目前诊断NAFLD以及区分单纯性脂肪肝和NASH的唯一方法,但予哪些患者行活检以及何时行活检尚缺乏明确指标。目前脂肪肝的治疗尚缺乏有效的药物,主要是纠正潜在危险因素、合理用药以及对终末期肝病进行肝移植术。本文就近年来对NAFLD的诊断和治疗进展作一介绍。

Along with the elevation of living standard and changing of life style in the past few years, the prevalence of nonalcoholic fatty liver disease （NAFLD） has stepped up significantly and becoming a common cause of chronic liver diseases in our country. Some of the patients with NAFLD may progress to liver fibrosis and cirrhosis. Ultrasonography is the most commonly used method for the diagnosis of NAFLD, but its specificity is not high, and is not reliable for detecting nonalcoholic steatohepatitis （NASH） and quantifying liver fibrosis. Although liver biopsy is currently the sole method for the definite diagnosis of NAFLD, and for the differentiation of simple fatty liver from NASH, there is still no definite guideline to indicate for whom and when liver biopsy should be performed. Fatty liver is still short of specific effective drugs. Currently the treatment is mainly focused on ameliorating the potential risk factors, rational use of drugs, and liver transplantation for patients with end-stage liver disease. This article reviews the diagnosis and treatment of NAFLD in recent years.