Goddard C J, Warnes T W
Liver Unit, Manchester Royal Infirmary, UK.
Dig Dis. 1992;10(4):218-26. doi: 10.1159/000171360.
Asymptomatic patients with raised liver enzymes are frequently encountered in clinical practice. The commonest lesion in such patients appears to be fatty liver, which may be found in those only modestly overweight. Proven treatments other than abstention from alcohol and weight loss are available for approximately 20% of asymptomatic people with abnormal liver enzymes. However, if experimental therapies are taken into account this would rise to over 50%, making an early accurate diagnosis important. Most conditions can be diagnosed non-invasively, especially in those people with markedly abnormal transaminases. The recent introduction of new non-invasive tests decreases the need for liver biopsy for diagnostic purposes, however liver biopsy retains an important role in establishing patient prognosis and response to treatment.
临床上经常会遇到肝功能酶升高但无症状的患者。这类患者最常见的病变似乎是脂肪肝，在体重仅略有超重的人群中也可能出现。除了戒酒和减肥外，约20%无症状肝功能酶异常的患者有已证实有效的治疗方法。然而，如果将实验性疗法考虑在内，这一比例将升至50%以上，因此早期准确诊断很重要。大多数情况可以通过非侵入性方法诊断，尤其是转氨酶明显异常的患者。最近新的非侵入性检测方法的引入减少了诊断性肝活检的需求，然而肝活检在确定患者预后和对治疗的反应方面仍起着重要作用。
