非酒精性脂肪性肝病无创诊断研究进展

Research Progress in Non-invasive Diagnosis of Non-alcoholic Fatty Liver Disease

非酒精性脂肪性肝病是全球最常见的慢性肝病。据估计,全球约25%的成年人患有非酒精性脂肪性肝病,且患病率逐年增加。非酒精性脂肪性肝病的疾病谱涵盖非酒精性脂肪肝、非酒精性脂肪性肝炎、非酒精性脂肪性肝炎相关纤维化、肝硬化和肝细胞癌。肝活检作为非酒精性脂肪性肝病诊断和分期的“金标准”,因有创性、取样变异和评价不一致等局限性限制了其广泛应用。随着进展为非酒精性脂肪性肝炎的患者数量增加,特别是疾病严重程度较重的病人增多,临床上迫切需要有效治疗药物,也迫切需要开发无创标志物来筛查、诊断、监测患者和判断疗效。对非酒精性脂肪性肝病的无创诊断研究进展进行综述,包括对脂肪变的评估、非酒精性脂肪性肝炎的诊断和纤维化的评估。

Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease worldwide with an increasing rate of morbidity year by year,affecting 25%of the global adult population.Its disease spectrum covers non-alcoholic fatty liver(NAFL),nonalcoholic steatohepatitis(NASH),NASH-related fibrosis,cirrhosis and hepatocellular carcinoma.Liver biopsy,as the"gold standard"for the diagnosis and staging of NAFLD,could not be widely used because of its limitations such as invasiveness,sampling variability and interobservers/intraobservers variability.With the increasing number of NASH patients,there is an urgent need for effective therapeutic agents,and a more urgent need to develop non-invasive markers to screen,diagnose and monitor patients,and evaluate the efficacy.This article reviews the research progress in non-invasive diagnosis of non-alcoholic fatty liver disease,including assessment of steatosis,diagnosis of NASH,and assessment of liver fibrosis.