Kobyliak Nazarii, Abenavoli Ludovico
Department of Endocrinology, Bogomolets National Medical University, Kiev, Ukraine, address: 01610, Pushkinska 22a.
Rev Recent Clin Trials. 2014;9(3):159-69. doi: 10.2174/1574887109666141216102231.
Liver biopsy, since 1883, when were first performed, became the gold standard to confirm the earlier stages of fibrosis and grading of non-alcoholic fatty liver disease (NAFLD) and for distinguishing simple steatosis from non- alcoholic steatohepatitis (NASH). General limitations of liver biopsy are sampling error and inter- and intraobserver variability. Also procedure is invasive and that's why associated with some potential adverse effects and complications which may be minor (pain or vagal reactions, transient hypotension) or major such as visceral perforation, bile peritonitis or significant bleeding. Presence of steatosis, hepatocellular injury in the form of ballooning, lobular inflammation and perisinusoidal fibrosis, usually with a zone 3 distribution are considered to be most important histological features of adult NAFLD which may differ from bariatric surgery or pediatric patients. In addition, grading and staging and current semiquantitative systems for NAFLD assessment are discussed.
自1883年首次进行肝活检以来，它已成为确认非酒精性脂肪性肝病（NAFLD）纤维化早期阶段和分级以及区分单纯性脂肪变性与非酒精性脂肪性肝炎（NASH）的金标准。肝活检的一般局限性包括抽样误差以及观察者间和观察者内的变异性。此外，该检查具有侵入性，这就是为什么它会伴有一些潜在的不良反应和并发症，这些反应和并发症可能较轻（疼痛或迷走神经反应、短暂性低血压），也可能较严重，如内脏穿孔、胆汁性腹膜炎或严重出血。脂肪变性、气球样变形式的肝细胞损伤、小叶炎症和窦周纤维化的存在，通常呈3区分布，被认为是成人NAFLD最重要的组织学特征，这可能与减肥手术或儿科患者不同。此外，还讨论了NAFLD评估的分级、分期和当前的半定量系统。
