Department of Internal Medicine, Brown University, Providence, RI, USA.
Department of Gastroenterology, Brown University, Providence, RI, USA.
Cleve Clin J Med. 2018 Aug;85(8):612-617. doi: 10.3949/ccjm.85a.17103.
Primary care physicians are at the forefront in screening for abnormal levels of liver enzymes and investigating the likely causes by obtaining a detailed history and physical examination, followed by appropriate laboratory and diagnostic workup. This review outlines common causes for the two main mechanisms of liver injury--cholestasis and hepatocellular insult--and explores the associated risk factors, methods of diagnosis, and management, with a focus on nonalcoholic fatty liver disease, one of the most often encountered causes of abnormal liver enzyme levels.
初级保健医生在筛查肝酶异常水平方面处于前沿地位，通过详细的病史和体格检查，然后进行适当的实验室和诊断性检查，来调查可能的原因。本文概述了两种主要的肝损伤机制（胆汁淤积和肝细胞损伤）的常见原因，并探讨了相关的危险因素、诊断方法和治疗方法，重点介绍了非酒精性脂肪性肝病，这是非酒精性肝酶异常水平最常见的原因之一。
