Gietka Jan Andrzej
Oddział I, Wojewódzki Szpital Zakaźny w Warszawie.
Przegl Epidemiol. 2011;65(1):27-34.
Assessment of liver fibrosis in patients with chronic hepatitis C (CHC) is essential for determination of prognosis, monitoring of the disease and guiding therapeutic decisions. Current gold standard for diagnosis of hepatic fibrosis is liver biopsy. Since it has several limitations and risks there is ongoing development of alternative means to assess fibrosis. In recent years intensive research in the field of noninvasive assessment of liver fibrosis allowed to establish few laboratory markers, that answer some questions about severity of the disease. Among these methods there are direct indices using parameters reflecting processes of fibrogenesis and fibrolysis as well as indirect indices using widely available laboratory parameters. This review presents 9 different simple markers with an overview of their statistical performance in determining liver fibrosis and their potential role in management of patients with CHC. Despite conducting many validating studies many questions remain about their indications, accuracy and a need of validation before they are put into widespread use. Further evaluation of noninvasive methods of liver fibrosis prediction is a priority in clinical hepatology research.
评估慢性丙型肝炎（CHC）患者的肝纤维化对于确定预后、监测疾病以及指导治疗决策至关重要。目前诊断肝纤维化的金标准是肝活检。由于肝活检存在多种局限性和风险，因此一直在开发评估纤维化的替代方法。近年来，在肝纤维化非侵入性评估领域的深入研究使得能够建立一些实验室标志物，这些标志物回答了有关疾病严重程度的一些问题。在这些方法中，有使用反映纤维生成和纤维溶解过程参数的直接指标，以及使用广泛可用实验室参数的间接指标。本综述介绍了9种不同的简单标志物，并概述了它们在确定肝纤维化方面的统计性能及其在CHC患者管理中的潜在作用。尽管进行了许多验证研究，但在它们被广泛应用之前，关于其适应症、准确性以及验证需求仍存在许多问题。肝纤维化预测非侵入性方法的进一步评估是临床肝病学研究的重点。
