非酒精性脂肪性肝病血清无创诊断模型研究进展

Research Progress of Serum Noninvasive Diagnostic Models for Nonalcoholic Fatty Liver Disease

非酒精性脂肪性肝病(NAFLD)疾病谱包括非酒精性脂肪肝、非酒精性脂肪性肝炎(NASH)、肝纤维化及肝硬化。而肝脏炎症及纤维化程度可决定NAFLD患者的长期预后,故早期监测疾病进展具有重要意义。目前,肝活检是评估NAFLD患者肝脏脂肪变、炎症及纤维化分期的金标准,但因其存在有创及不良反应等缺点,故临床未能广泛应用。近年来,NAFLD相关血清无创诊断标志物或模型的研究越来越多。未来,深入了解用于评估肝脏脂肪变、NASH、进展期肝纤维化的各种血清无创诊断模型的临床应用价值及不足,有助于临床合理使用,同时减少肝活检需求。

Nonalcoholic fatty liver disease(NAFLD)comprises a spectrum of diseases of nonalcoholic fatty liver,nonalcoholic steatohepatitis(NASH),fibrosis and cirrhosis.The degree of liver inflammation and fibrosis can determine the long-term prognosis of NAFLD patients,so early monitoring of disease progression is of great importance.Currently liver biopsy is considered the gold standard for evaluating the stages of liver steatosis,inflammation and fibrosis in patients with NAFLD,but this method is not widely applied in clinical work because of some limitations such as invasiveness and adverse events.In recent years,the studies about serum noninvasive diagnostic markers or models related to NAFLD have been continuously increasing.In the future,in-depth understanding of the clinical application value and shortcomings of various serum non-invasive diagnostic models for evaluating liver steatosis,NASH and progressive liver fibrosis will be helpful for the rational clinical use and reduce the need for liver biopsy.