Day James W, Rosenberg William M
Research Fellow, The Institute for Liver and Digestive Health, University College London Division of Medicine, University College London, London NW3 2PF.
Professor of Liver Medicine, The Institute for Liver and Digestive Health, University College London Division of Medicine, University College London, London.
Br J Hosp Med (Lond). 2018 Dec 2;79(12):694-699. doi: 10.12968/hmed.2018.79.12.694.
Liver disease is a major cause of mortality both globally and in the UK. The earlier liver fibrosis is detected, the sooner interventions can be implemented, including lifestyle changes and medications. Non-invasive tests for liver fibrosis are beginning to augment and replace liver biopsy in assessment of liver fibrosis because of their ease of use, lack of complications and reproducibility. The enhanced liver fibrosis (ELF) test is a blood test that measures three molecules involved in liver matrix metabolism to give a score reflecting the severity of liver fibrosis. This article reviews the evidence supporting ELF as a diagnostic test, a prognostic marker and its use in disease monitoring. In doing so it highlights the important role ELF plays in the early recognition of liver fibrosis facilitating timely referral to a liver specialist. The ELF test is useful in primary, secondary and tertiary care, not only allowing earlier diagnosis and more accurate prognosis, but also providing the opportunity to personalize treatment based on the patient's response.
肝病在全球及英国都是主要的死亡原因。肝纤维化发现得越早，就能越早实施干预措施，包括改变生活方式和用药。由于其使用便捷、无并发症且具有可重复性，用于肝纤维化的非侵入性检测开始在肝纤维化评估中补充并取代肝活检。增强肝纤维化（ELF）检测是一种血液检测，它测量参与肝脏基质代谢的三种分子，以得出一个反映肝纤维化严重程度的分数。本文综述了支持ELF作为诊断检测、预后标志物及其在疾病监测中应用的证据。在此过程中，它强调了ELF在早期识别肝纤维化方面所起的重要作用，有助于及时转诊至肝脏专科医生处。ELF检测在初级、二级和三级医疗保健中都很有用，不仅能实现更早诊断和更准确的预后，还能根据患者的反应提供个性化治疗的机会。
