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异常肝脏血液检查:肝病专家的处理方法。

Abnormal Liver Blood Tests: Hepatologist Approach.

机构信息

Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia.

Zemun Medical Center, Gastroenterology Department, Medical School, University of Belgrade, Belgrade, Serbia.

出版信息

Dig Dis. 2022;40(2):206-214. doi: 10.1159/000517110. Epub 2021 May 10.

Abstract

BACKGROUND

Available data suggest that the prevalence of chronic liver disease (CLD) and primary liver cancer is rising in Europe and represents a major public health problem. Predictions are showing that these trends will continue to rise in the upcoming years.

SUMMARY

Alcohol-related liver disease, nonalcohol fatty liver disease, and viral hepatitis B and hepatitis C are the leading causes of liver cirrhosis and primary liver cancer in Europe. Drug-induced liver injury represents a major cause of acute hepatitis, while liver transplantation is the second most common solid organ transplantation in the world. Patients with CLD have increasing rates of hospitalization, longer hospital stays, and more adverse outcomes compared to the other chronic conditions. Direct targeting of risk factors can prevent complications of advanced liver disease and improve outcome. Patients with CLD should be referred to a hepatologist for assessment of the stage of liver disease, for specific treatment and screening for hepatocellular carcinoma. Moreover, patients with unknown etiology of abnormal liver blood tests should be referred to a hepatologist for assessment of liver disease, as well as for prevention and treatment of complications of cirrhosis and/or portal hypertension. Key Messages: CLD is amenable to prevention and treatment, while disease management strategies need to improve in order to reduce the burden of liver disease and deaths due to end-stage liver diseases.

摘要

背景

现有数据表明,欧洲慢性肝病(CLD)和原发性肝癌的患病率正在上升,这是一个主要的公共卫生问题。预测显示,这些趋势在未来几年还将继续上升。

概述

在欧洲,酒精性肝病、非酒精性脂肪性肝病、乙型肝炎和丙型肝炎是导致肝硬化和原发性肝癌的主要原因。药物性肝损伤是急性肝炎的主要原因,而肝移植是世界上第二常见的实体器官移植。与其他慢性疾病相比,CLD 患者的住院率更高、住院时间更长、不良预后更多。直接针对危险因素可以预防晚期肝病的并发症并改善预后。应将 CLD 患者转介给肝病专家进行肝病分期评估,进行特定治疗和筛查肝细胞癌。此外,对于不明原因的肝血液检查异常的患者,也应转介给肝病专家进行肝病评估,以及预防和治疗肝硬化和/或门静脉高压症的并发症。

关键信息

CLD 是可以预防和治疗的,而疾病管理策略需要改进,以减轻肝病负担和因终末期肝病导致的死亡。

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