非酒精性脂肪性肝炎的无创诊断方法

Research advances in noninvasive diagnostic methods for nonalcoholic steatohepatitis

非酒精性脂肪性肝病从发病率方面来看已成为全球第一大肝病,并且正在逐渐成为发达国家肝移植的是首位病因,其疾病谱包括单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)、肝纤维化及肝硬化,与单纯性脂肪肝相比,NASH并非良性疾病,可发展为晚期肝硬化及肝癌。目前NASH诊断的金标准为肝活组织检查,但因有侵入性及潜在的并发症出现几率而限制了其广泛应用。目前临床上尝试采用非侵入性诊断方法替代肝穿刺活组织检查来诊断NASH,但尚缺乏成熟可靠的无创判定方法,因此仍需要不断努力探索改进。现将近年来国内外对NASH无创诊断方法的有关进展作一概述。

Nonalcoholic fatty liver disease（ NAFLD） has become the most common liver disease in the world in terms of incidence rate and is gradually becoming the first cause of liver transplantation in developed countries. The spectrum of this disease includes simple fatty liver,nonalcoholic steatohepatitis（ NASH）,liver fibrosis,and liver cirrhosis. Compared with simple fatty liver,NASH is not a benign disease and can progress to advanced cirrhosis and liver cancer. At present,liver biopsy remains the gold standard for the diagnosis of NASH,but its application is limited by its invasive and potential complications. Noninvasive diagnostic methods have been developed for the diagnosis of NASH in clinical practice to replace liver biopsy; however,there still lack mature and reliable noninvasive methods,and continuous efforts should be made for further exploration and modification. This article reviews the recent research advances in noninvasive diagnostic methods for NASH in China and foreign countries.