非酒精性脂肪性肝病的病例发现策略
Case-finding strategies in non-alcoholic fatty liver disease.
作者信息
Boursier Jerome, Tsochatzis Emmanuel A
机构信息
Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, Angers, France.
Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France.
出版信息
JHEP Rep. 2020 Dec 5;3(2):100219. doi: 10.1016/j.jhepr.2020.100219. eCollection 2021 Apr.
Among the large population of patients with non-alcoholic fatty liver disease (NAFLD), identifying those with advanced disease remains challenging. Many patients are diagnosed late, following the development of liver-related complications, leading to poor clinical outcomes. Accumulating evidence suggests that using non-invasive tests for liver fibrosis in patients with metabolic risk factors improves the detection of patients in need of specialised management and is cost-effective. Because of the vast number of patients requiring evaluation, the active participation of general practitioners and physicians who manage patients with metabolic disorders, such as diabetologists, is crucial; this calls for the increased awareness of NAFLD beyond liver clinics. Non-invasive case-finding strategies will need to be further validated and generalised for upcoming drug therapies to have the required impact on the worldwide burden of NAFLD.
在大量非酒精性脂肪性肝病(NAFLD)患者中,识别出患有晚期疾病的患者仍然具有挑战性。许多患者在出现肝脏相关并发症后才被确诊,导致临床预后不良。越来越多的证据表明,对有代谢风险因素的患者使用非侵入性肝纤维化检测方法,可提高对需要专科治疗患者的检出率,且具有成本效益。由于需要评估的患者数量众多,全科医生以及管理代谢紊乱患者的医生(如糖尿病专家)的积极参与至关重要;这就要求提高非肝脏专科诊所对NAFLD的认识。对于即将到来的药物治疗,非侵入性病例发现策略需要进一步验证和推广,以便对全球NAFLD负担产生所需的影响。
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