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[遗传性肝病的临床诊断与治疗再评价]

[Reappraisal on the clinical diagnosis and treatment of hereditary liver diseases].

作者信息

Jia J D

机构信息

Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2024 Sep 20;32(9):769-771. doi: 10.3760/cma.j.cn501113-20240826-00393.

Abstract

Hereditary liver diseases are rare conditions characterized by a wide variety of types and very low incidence rate for each one. Their clinical manifestations are diverse, and diagnosis often requires specialized testing, posing a high likelihood of missed or misdiagnosis. Systemic learning the basic knowledge and classification of hereditary liver diseases, as well as an understanding of the clinical features, laboratory findings, imaging, and pathological features of the relatively common hereditary liver diseases in adults, such as Wilson's disease, hemochromatosis, and alpha-1 antitrypsin deficiency, is essential. Targeted genetic testing can aid in the timely identification and correct diagnosis of these diseases. Once the etiology is revealed, appropriate treatment can often improve the clinical outcomes and quality of life. Cell therapy and gene therapy represent future directions and may offer the chance of cure for certain conditions. Currently, for patients who have progressed to end-stage liver disease, liver transplantation remains the ultimate treatment option and mostly yield excellent long-term prognosis if the indication and timing are appropriate.

摘要

遗传性肝病是一类罕见疾病,其类型繁多,每种类型的发病率都很低。它们的临床表现多样,诊断通常需要专门的检测,误诊或漏诊的可能性很高。系统学习遗传性肝病的基本知识和分类,以及了解成人相对常见的遗传性肝病(如威尔逊病、血色素沉着症和α-1抗胰蛋白酶缺乏症)的临床特征、实验室检查结果、影像学和病理特征至关重要。针对性的基因检测有助于及时识别和正确诊断这些疾病。一旦病因明确,适当的治疗通常可以改善临床结局和生活质量。细胞治疗和基因治疗代表了未来的方向,可能为某些疾病提供治愈的机会。目前,对于已进展至终末期肝病的患者,肝移植仍然是最终的治疗选择,如果适应证和时机合适,大多能产生良好的长期预后。

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