中国和意大利非酒精性脂肪性肝病诊疗指南的异同解读

Guidelines for assessment and management of nonalcoholic fatty liver disease in China and Italy:differences and similarities

非酒精性脂肪性肝病(NAFLD)是常见病,2010年中国和意大利先后更新诊疗指南,对照解读有助于对本病的全面理解。两指南观点并无原则上差异,流行病学内容基本一致,两指南一致强调病理学是诊断NAFLD分期的金标准,意大利指南偏重临床诊断流程和对诊断方法的评价;而中国指南致力于制定临床、病理学、影像学等诊断标准。目前尚无NAFLD的特效治疗方法,两指南均主张使用改善胰岛素抵抗的措施和药物,中国指南推荐较多保肝抗炎药物。

Nonalcoholic fatty liver disease（NAFLD） is a common disorder. An overall understanding of this disease may be improved by comparative interpretation of guidelines for assessment and management of NAFLD updated 2010 in China and in Italy. The two guidelines do not differ in principle,with general agreement on epide- miology and consistent highlight on histopathology as the gold standard for diagnosis and identification of NAFLD. However, the Italian guidelines emphasize more on algorithm for clinical diagnosis and comments for different diag- nostic modalities, while the Chinese guidelines focus on development of a diagnostic criteria which include clinical presentations, pathology and imaging. At present, there remains no specific treatment for NAFLD. While both guidelines recommend measures and drugs to improve insulin resistance, the use of hepatoprotective or anti- in- flammatory agents is more involved in Chinese guidelines.