Xu J H, Yu Y Y, Xu X Y
Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Feb 20;29(2):108-110. doi: 10.3760/cma.j.cn501113-20210102-00002.
Liver cirrhosis is the final stage of many chronic liver diseases, and is still a heavy disease burden. The proportion of liver cirrhosis caused by the hepatitis B virus is declining, while that caused by the non-alcoholic fatty liver disease (metabolic-associated fatty liver disease) is rising. Several predictive models and techniques such as transient elastography have been used for the early non-invasive evaluation of liver cirrhosis. Effective etiological treatment and complication management are the possible key to reverse and recompense liver function during liver cirrhosis treatment. In recent years, the effectiveness and availability of anti-hepatitis B and C virus drugs have been significantly improved, which provides the basis for effective etiological treatment of liver cirrhosis. However, there is still a lack of etiological treatment measures for non-alcoholic fatty liver disease. Therefore, in addition to focusing on common complications, we should also manage "rare" complications. This article reviews the changes in epidemiological characteristics, the update of the natural history concepts, diagnostic evaluation methods, and the treatment measures for liver cirrhosis.
肝硬化是许多慢性肝病的终末期,仍然是一个沉重的疾病负担。由乙型肝炎病毒引起的肝硬化比例正在下降,而由非酒精性脂肪性肝病(代谢相关脂肪性肝病)引起的比例正在上升。几种预测模型和技术,如瞬时弹性成像,已被用于肝硬化的早期非侵入性评估。有效的病因治疗和并发症管理可能是肝硬化治疗期间逆转和恢复肝功能的关键。近年来,抗乙型和丙型肝炎病毒药物的有效性和可及性有了显著提高,这为肝硬化的有效病因治疗提供了基础。然而,非酒精性脂肪性肝病仍然缺乏病因治疗措施。因此,除了关注常见并发症外,我们还应管理“罕见”并发症。本文综述了肝硬化流行病学特征的变化、自然史概念的更新、诊断评估方法以及治疗措施。