School of Medicine and Pharmacology, University of Western Australia, Sir Charles Gairdner Hospital Unit, Nedlands, Western Australia, Australia.
J Dig Dis. 2011 Feb;12(1):10-6. doi: 10.1111/j.1751-2980.2010.00471.x.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the USA and many other parts of the world. Its prevalence continues to rise; currently affecting about one in four adults and 10% of children in the USA. NAFLD represents a wide spectrum of conditions ranging from fatty liver, which in general follows a benign, no-progressive clinical course, to nonalcoholic steatohepatitis (NASH), a more serious form of NAFLD that may progress to cirrhosis and end-stage liver disease. Currently, the diagnosis of NASH requires an invasive liver biopsy with drawbacks of sampling and interpretation error. Clinical risk factors for NASH include diabetes and the metabolic syndrome; however, these are not sufficiently predictive of the condition by themselves. Routine liver enzyme levels are not reliable; however, novel plasma hepatocyte cell death markers either alone or in combination with clinical risk factors are potential non-invasive diagnostic tools for the future. This review provides a concise overview of the role non-invasive diagnostic tools for the differentiation of fatty liver from NASH as well as for the determination of presence and extent of fibrosis.
非酒精性脂肪性肝病（NAFLD）是美国和世界许多其他地区最常见的慢性肝病。其患病率持续上升；目前，美国约有四分之一的成年人和 10%的儿童受到影响。NAFLD 代表了一系列广泛的疾病状态，从脂肪性肝病（通常表现为良性、无进展性临床过程）到非酒精性脂肪性肝炎（NASH），这是一种更严重的 NAFLD 形式，可能进展为肝硬化和终末期肝病。目前，NASH 的诊断需要进行有创性肝活检，但存在取样和解释误差的缺点。NASH 的临床危险因素包括糖尿病和代谢综合征；然而，这些因素本身并不能充分预测病情。常规的肝酶水平不可靠；然而，新型血浆肝细胞死亡标志物单独或与临床危险因素联合应用可能是未来潜在的非侵入性诊断工具。本综述简要概述了非侵入性诊断工具在区分脂肪性肝病与 NASH 以及确定纤维化的存在和程度方面的作用。
