Diagnosis and assessment of liver cirrhosis
-
摘要: 肝硬化是各种慢性肝病的终末阶段,如何早期诊断肝硬化及对肝硬化进行分期并进行有效病情评估,在临床工作中尤为重要。介绍了肝脏穿刺病理学检查、血清学检查及影像学检查在肝硬化的临床诊断中的应用,以及肝脏储备功能评估、并发症评估和预后评估的研究进展。指出随着分子生物学及影像学诊断技术的发展,必将大力提高无创诊断的准确性和特异性,并深入完善疾病的评估体系。Abstract: Liver cirrhosis is the end stage of various chronic liver diseases. Early diagnosis and staging of liver cirrhosis, as well as effective disease assessment, are of great clinical significance. The application of liver biopsy, serological testing, and radiological examination in the clinical diagnosis of liver cirrhosis and the research advances in evaluation of liver reserve function, complications, and prognosis are reviewed. It is pointed out that with the development of molecular biological and imaging techniques, the accuracy and specificity of noninvasive diagnosis will be increased, and the disease assessment system will be improved.
-
Key words:
- liver cirrhosis /
- early diagnosis /
- prognosis /
- editorial
-
[1]HU XQ.Is liver biopsy the gold standard for assessment of liver fibrosis?[J].Chin J Hepatol, 2012, 20 (8) :568-570. (in Chinese) 胡锡琪.肝穿刺活组织检查是评估肝纤维化的金标准吗?[J].中华肝脏病杂志, 2012, 20 (8) :568-570. [2]SEBASTIANI G.Non-invasive assessment of liver fibrosis in chronic liver diseases:implementation in clinical practice and decisional algorithms[J].World J Gastroenterol, 2009, 15 (18) :2190-2203. [3]IMBERT-BISMUT F, RATZIU V, PIERONI L, et al.Biochemical markers of liver fibrosis in patients with hepatitis C virus infection:a prospective study[J].Lancet, 2001, 357 (9262) :1069-1075. [4]FORNS X, AMPURDANS S, LLOVET JM, et al.Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model[J].Hepatology, 2002, 36 (4 Pt 1) :986-992. [5]WAI CT, GREENSON JK, FONTANA RJ, et al.A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C[J].Hepatology, 2003, 38 (2) :518-526. [6] STERLING RK, LISSEN E, CLUMECK N, et al.Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection[J].Hepatology, 2006, 43 (6) :1317-1325. [7] ADAMS LA, BULSARA M, ROSSI E, et al.Hepascore:an accurate validated predictor of liver fibrosis in chronic hepatitis C infection[J].Clin Chem, 2005, 51 (10) :1867-1873. [8]CALSP, OBERTI F, MICHALAK S, et al.A novel panel of blood markers to assess the degree of liver fibrosis[J].Hepatology, 2005, 42 (6) :1373-1381. [9] ZENG MD, LU LG, MAO YM, et al.Prediction of significant fibrosis in HBeAg-positive patients with chronic hepatitis B by a noninvasive model[J].Hepatology, 2005, 42 (6) :1437-1445. [10] ZHOU K, GAO CF, ZHAO YP, et al.Simpler score of routine laboratory tests predicts liver fibrosis in patients with chronic hepatitis B[J].J Gastroenterol Hepatol, 2010, 25 (9) :1569-1577. [11] CALLEWAERT N, van VLIERBERGHE H, van HECKE A, et al.Noninvasive diagnosis of liver cirrhosis using DNA sequencerbased total serum protein glycomics[J].Nat Med, 2004, 10 (4) :429-434. [12]XU MY, QU Y, JIA XF, et al.Serum proteomic MRM identify peptide ions of transferrin as new fibrosis markers in chronic hepatitis B[J].Biomed Pharmacother, 2013, 67 (7) :561-567. [13]FRIEDRICH-RUST M, ONG MF, MARTENS S, et al.Performance of transient elastography for the staging of liver fibrosis:a meta-analysis[J].Gastroenterology, 2008, 134 (4) :960-974. [14]Review Panel for Liver Stiffness Measurement.Recommendations for the clinical application of transient elastograph in liver fibrosis assessment[J].Chin J Hepatol, 2013, 21 (6) :420-424. (in Chinese) 肝脏硬度评估小组.瞬时弹性成像技术诊断肝纤维化专家意见[J].中华肝脏病杂志, 2013, 21 (6) :420-424. [15]SEIMIYA M, OHNO S, YAMAMOTO H, et al.Child-Pugh score is altered by the albumin measurement method[J].Hepatology, 2013, 57 (5) :2093-2094. [16]Joint Research Group for Major Project in the Twelfth Five-Year Plan Supported by China Ministry of Science and Technology.Comprehensive management of clinical diagnosis, assessment, and antiviral treatment of HBV-related liver cirrhosis[J].Chin J Dig, 2014, 34 (2) :77-84. (in Chinese) 科技部十二五重大专项联合课题组.乙型肝炎病毒相关肝硬化的临床诊断、评估和抗病毒治疗的综合管理[J].中华消化杂志, 2014, 34 (2) :77-84. [17]VIZZUTTI F, ARENA U, ROMANELLI RG, et al.Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis[J].Hepatology, 2007, 45 (5) :1290-1297. [18]CHEN YP, ZHANG Q, DAI L, et al.Is transient elastography valuable for high-risk esophageal varices prediction in patients with hepatitis-B-related cirrhosis?[J].J Gastroenterol Hepatol, 2012, 27 (3) :533-539. [19]LISOTTI A, AZZAROLI F, BUONFIGLIOLI F, et al.Indocyanine green retention test as a noninvasive marker of portal hypertension and esophageal varices in compensated liver cirrhosis[J].Hepatology, 2014, 59 (2) :643-650. [20]HUO TI, WU JC, LIN HC, et al.Evaluation of the increase in model for end-stage liver disease (DeltaMELD) score over time as a prognostic predictor in patients with advanced cirrhosis:risk factor analysis and comparison with initial MELD and Child-TurcottePugh score[J].J Hepatol, 2005, 42 (6) :826-832. [21]RUZ-DEL-RBOL L, ACHCAR L, SERRADILLA R, et al.Diastolic dysfunction is a predictor of poor outcomes in patients with cirrhosis, portal hypertension, and a normal creatinine[J].Hepatology, 2013, 58 (5) :1732-1741. [22] KIM WR, BIGGINS SW, KREMERS WK, et al.Hyponatremia and mortality among patients on the liver-transplant waiting list[J].N Engl J Med, 2008, 359 (10) :1018-1026.
本文二维码
计量
- 文章访问数: 2356
- HTML全文浏览量: 66
- PDF下载量: 915
- 被引次数: 0