Frith James, Jones David, Newton Julia L
Biomedical Research Centre in Ageing, Liver Theme and Institute of Cellular Medicine, Newcastle University, Newcastle NE2 4HH, UK.
Age Ageing. 2009 Jan;38(1):11-8. doi: 10.1093/ageing/afn242. Epub 2008 Nov 22.
The prevalence of chronic liver disease is increasing in the elderly population. With a mostly asymptomatic or non-specific presentation, these diseases may easily go undiagnosed. Abnormal liver function tests of unknown cause are a common reason for referral to secondary care. Investigating the older person with abnormal liver function is important; even with mild abnormalities, the same vigilance should be applied to an older person as in a young person. Liver biopsy is safe but often overlooked in this age group and may provide useful information to diagnose, direct therapy and prognosticate. Treatment options are similar for all age groups, with a few subtle differences, although further evidence is frequently required for the older population. Morbidity and age-adjusted mortality are often more severe in older people, and therefore early diagnosis and intervention is important. Presented here are the most common chronic liver diseases that geriatricians are likely to encounter in clinical practise. Their epidemiology, clinical features, investigation, treatment and mortality are described with a particular focus on the elderly population.
慢性肝病在老年人群中的患病率正在上升。这些疾病大多表现为无症状或非特异性症状，很容易被漏诊。不明原因的肝功能检查异常是转诊至二级医疗机构的常见原因。对肝功能异常的老年人进行调查很重要；即使是轻度异常，对老年人也应像对年轻人一样保持警惕。肝活检是安全的，但在这个年龄组中常常被忽视，它可能为诊断、指导治疗和预测预后提供有用信息。所有年龄组的治疗选择相似，虽有一些细微差别，但老年人群往往还需要更多证据。老年人的发病率和年龄调整死亡率通常更严重，因此早期诊断和干预很重要。本文介绍了老年科医生在临床实践中可能遇到的最常见慢性肝病。特别针对老年人群描述了它们的流行病学、临床特征、检查、治疗和死亡率。
