Castera Laurent
Service d'Hépato-Gastroentérologie, CHU Bordeaux, Hôpital Haut Lévêque, Avenue Magellan, 33604 Pessac, France.
Expert Rev Gastroenterol Hepatol. 2008 Aug;2(4):541-52. doi: 10.1586/17474124.2.4.541.
Prognosis and management of chronic liver diseases greatly depend on the amount and progression of liver fibrosis. Although liver biopsy is still considered as the gold standard to evaluate fibrosis in the liver, it is an invasive procedure, with rare but potentially life-threatening complications, and is prone to sampling errors. These limitations have stimulated the search for new noninvasive approaches. A number of methods, including serum indices and the measurement of liver stiffness using transient elastography, have been proposed for the noninvasive assessment of hepatic fibrosis, mainly in patients with chronic hepatitis C. It can be anticipated that these noninvasive methods will become an important tool in clinical practice in the near future. This review is aimed at discussing the advantages and limits of these methods and the perspectives for their rationale for use in clinical practice.
慢性肝病的预后和管理在很大程度上取决于肝纤维化的程度和进展。尽管肝活检仍被视为评估肝脏纤维化的金标准,但它是一种侵入性操作,存在罕见但可能危及生命的并发症,且容易出现抽样误差。这些局限性促使人们寻找新的非侵入性方法。已经提出了许多方法,包括血清指标以及使用瞬时弹性成像测量肝脏硬度,用于肝纤维化的非侵入性评估,主要针对慢性丙型肝炎患者。可以预期,这些非侵入性方法在不久的将来将成为临床实践中的重要工具。这篇综述旨在讨论这些方法的优点和局限性以及它们在临床实践中应用的理论依据。