McCullough Arthur J
Case Western Reserve University, 2500 Metro Health Drive, Cleveland, OH 44109, USA.
Clin Liver Dis. 2004 Aug;8(3):521-33, viii. doi: 10.1016/j.cld.2004.04.004.
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease in the United States. The histologic spectrum of NAFLD ranges from steatosis liver alone to nonalcoholic steatohepatitis (NASH), which is the most serious form of NAFLD. NASH is a progressive fibrotic disease, in which cirrhosis and liver-related death occur in up to 20% and 12%, respectively, over a 10-year period. NASH-associated cirrhosis also can develop into subacute liver failure, progress to hepatocellular carcinoma, and reoccur post-transplantation. In contrast, steatosis alone has a more benign clinical course, although progression to cirrhosis has occurred in 3% of these patients. The major risk factors for fibrosis include diabetes or obesity, an aspartate aminotransferase/alanine aminotransferase ratio of greater than 1, age older than 50, and hepatic histology.
非酒精性脂肪性肝病(NAFLD)已成为美国最常见的慢性肝病。NAFLD的组织学范围从单纯性脂肪肝到非酒精性脂肪性肝炎(NASH),后者是NAFLD最严重的形式。NASH是一种进行性纤维化疾病,在10年期间,分别有高达20%和12%的患者发生肝硬化和肝相关死亡。NASH相关的肝硬化还可发展为亚急性肝衰竭,进展为肝细胞癌,并在移植后复发。相比之下,单纯性脂肪肝的临床病程较为良性,尽管这些患者中有3%发生了肝硬化。纤维化的主要危险因素包括糖尿病或肥胖、天冬氨酸转氨酶/丙氨酸转氨酶比值大于1、年龄超过50岁以及肝脏组织学。