Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA.
Curr Mol Med. 2010 Mar;10(2):166-72. doi: 10.2174/156652410790963321.
Non-alcoholic fatty liver disease (NAFLD) is a clinico-pathologic spectrum of conditions ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). Although simple or bland steatosis follows a relatively benign clinical course, NASH can potentially progress to cirrhosis (approximately 10 to 15 percent) and hepatocellular carcinoma. NAFLD occurs in an estimated 25 to 30 percent of the US general population, while NASH is reported in 2 to 3 percent of the population. Even though common explanation for the increased prevalence of NAFLD is the increased rate of obesity, the risk of developing NAFLD and NASH is not limited to overweight and obese individuals. Currently, the only way to diagnose NASH or to assess the stage of fibrosis is by obtaining a liver biopsy. Liver biopsy is invasive, expensive, and associated with potential risks, including post biopsy pain, bleeding, organ perforation, and even death; serious complications can occur in 0.3 percent of liver biopsies with 0.01 percent being fatal. This review examines the current strategies for development of the non-invasive techniques that will one day replace liver biopsy and serve as a non-invasive gold standard for the diagnosis and staging of NASH.
非酒精性脂肪性肝病（NAFLD）是一种临床病理谱疾病，其范围从单纯性脂肪变性到非酒精性脂肪性肝炎（NASH）。尽管单纯性或非炎症性脂肪变性具有相对良性的临床病程，但 NASH 可能会进展为肝硬化（约 10-15%）和肝细胞癌。NAFLD 在估计 25-30%的美国普通人群中发生，而 NASH 则在 2-3%的人群中报告。尽管肥胖率的增加是 NAFLD 患病率增加的常见解释，但发生 NAFLD 和 NASH 的风险并不仅限于超重和肥胖个体。目前，诊断 NASH 或评估纤维化阶段的唯一方法是获取肝活检。肝活检具有侵袭性、昂贵且存在潜在风险，包括活检后疼痛、出血、器官穿孔，甚至死亡；肝活检的严重并发症发生率为 0.3%，死亡率为 0.01%。这篇综述探讨了目前发展非侵入性技术的策略，这些技术将有一天取代肝活检，并作为 NASH 的诊断和分期的非侵入性金标准。
