Henry Zachary H, Argo Curtis K
Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA.
Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA.
Gastroenterol Clin North Am. 2020 Mar;49(1):45-62. doi: 10.1016/j.gtc.2019.09.002. Epub 2019 Dec 24.
Non-alcoholic fatty liver disease (NAFLD) figures prominently into the clinical hepatology landscape. NAFLD represents a disease spectrum comprising simple steatosis, steatosis with elevated liver enzymes, and non-alcoholic steatohepatitis (NASH), the entity with clear potential for fibrosis progression. Risk factors associated with fibrosis progression in NASH include histologic findings of lobular inflammation and any fibrosis as well as clinical comorbidities that include type 2 diabetes, obesity, and metabolic syndrome. Liver biopsy remains the gold standard in evaluating NASH; however, noninvasive methods are accumulating evidence for a growing role in identifying patients at increased risk to develop NASH, fibrosis, and potentially cirrhosis.
非酒精性脂肪性肝病（NAFLD）在临床肝病领域中占据重要地位。NAFLD代表了一种疾病谱，包括单纯性脂肪变性、伴有肝酶升高的脂肪变性以及非酒精性脂肪性肝炎（NASH），后者具有明确的纤维化进展潜力。与NASH纤维化进展相关的危险因素包括小叶炎症和任何纤维化的组织学表现以及临床合并症，如2型糖尿病、肥胖和代谢综合征。肝活检仍然是评估NASH的金标准；然而，非侵入性方法在识别发生NASH、纤维化及潜在肝硬化风险增加的患者方面发挥着越来越重要的作用，相关证据也在不断积累。
