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慢性肝病

Chronic Liver Disease

作者信息

Sharma Ashish, Nagalli Shivaraj

机构信息

Yuma Regional Medical Center

Abstract

Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes synthesis of clotting factors, other proteins, detoxification of harmful products of metabolism, and excretion of bile. CLD is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. The spectrum of etiologies is broad for chronic liver disease, which includes toxins, alcohol abuse for a prolonged time, infection, autoimmune diseases, genetic and metabolic disorders. Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix. The underlying mechanism of fibrosis and cirrhosis at a cellular level is the recruitment of stellate cells and fibroblasts, resulting in fibrosis, while parenchymal regeneration relies on hepatic stem cells. Chronic liver disease is an extremely common clinical condition, and the focus is done on the common etiologies, clinical manifestations, and management.

摘要

慢性肝病(CLD)是指肝功能进行性恶化超过六个月,包括凝血因子、其他蛋白质的合成,代谢有害产物的解毒以及胆汁的排泄。CLD是肝实质炎症、破坏和再生的持续过程,会导致纤维化和肝硬化。慢性肝病的病因范围广泛,包括毒素、长期酗酒、感染、自身免疫性疾病、遗传和代谢紊乱。肝硬化是慢性肝病的终末期,会导致肝脏结构破坏、广泛结节形成、血管重组、新生血管形成以及细胞外基质沉积。纤维化和肝硬化在细胞水平的潜在机制是星状细胞和成纤维细胞的募集,导致纤维化,而实质再生依赖于肝干细胞。慢性肝病是一种极为常见的临床病症,重点关注常见病因、临床表现及治疗。

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