Grigorescu Mircea
3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Croitorilor no. 19-21, 400162 Cluj-Napoca, Romania.
J Gastrointestin Liver Dis. 2006 Jun;15(2):149-59.
The assessment of liver fibrosis provides useful information not only for diagnosis but also for therapeutic decision. Although needle biopsy of the liver is the gold standard for fibrosis assessment, it has some technical limitations and risks. This has led to the development of noninvasive biochemical markers of liver fibrosis: direct markers which reflect extracellular matrix turnover and indirect markers which reflect alterations in hepatic function. Markers associated with matrix deposition or degradation and some cytokines implied in fibrosis may be used as individual markers or as combination of markers to generate an algorithm to evaluate the stage of fibrosis. Also, fibrosis may be predicted by using indirect markers as a single routine laboratory test or multicomponent indirect fibrosis tests. Serum markers are of great value not only in patients at risk for liver biopsy, but also as a part of the assessment of patients with chronic liver disease avoiding the invasive methods.
肝纤维化评估不仅为诊断提供有用信息，也为治疗决策提供依据。尽管肝脏穿刺活检是纤维化评估的金标准，但它存在一些技术局限性和风险。这促使了肝纤维化非侵入性生化标志物的发展：反映细胞外基质转换的直接标志物和反映肝功能改变的间接标志物。与基质沉积或降解相关的标志物以及一些参与纤维化的细胞因子可作为单个标志物或标志物组合，以生成评估纤维化阶段的算法。此外，可通过将间接标志物用作单一常规实验室检查或多组分间接纤维化检查来预测纤维化。血清标志物不仅对有肝活检风险的患者具有重要价值，也是避免采用侵入性方法评估慢性肝病患者的一部分。
