Consensus on the diagnosis and therapy of hepatic fibrosis(2019)
-
摘要: <正>肝纤维化或肝硬化在国际疾病分类-11(international classification of diseases,ICD-11)为DB93. 0。肝纤维化是指肝细胞外基质(即胶原、糖蛋白和蛋白多糖等)的弥漫性过度沉积与异常分布,是肝脏对慢性损伤的病理性修复反应,是各种慢性肝病向肝硬化发展过程中的关键步骤和影响慢性肝病预后的重要环节。肝纤维化进一步发展可引起肝小叶结构紊乱,肝细胞结节性再生,形成假小叶结构即肝硬化,临床上可见肝功能减退和门静脉高压症表现。肝纤维化在组织学上是可逆的,而
-
Key words:
- liver cirrhosis /
- diagnosis /
- therapeutics /
- consensus
-
[1] World Health Organization. ICD-11 for Mortality and Morbidity Statistics[EB/OL]. https://icd. who. int/browse11/l-m/en#/http://id. who. int/icd/entity/1377614074. [2] Hepatic Fibrosis Study Group of Chinese Liver Diseases Association. Consensus on evaluation of the diagnosis and efficacy of hepatic fibrosis[J]. Chin J Hepatol,2002,1(5):327-328.(in Chinese)中华肝脏病学会肝纤维化学组.肝纤维化诊断及疗效评估共识[J].中华肝脏病杂志,2002,1(5):327-328. [3] GUYATT GH,OXMAN AD,VIST GE,et al. GRADE:An emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ,2008,336(7650):924-926. [4] TAPPER EB,LOK A. Use of liver imaging and biopsy in clinical practice[J]. N Engl J Med,2017,377(23):2296-2297. [5] KNODELL RG,ISHAK KG,BLACK WC,et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis[J]. Hepatology,1981,1(5):431-435. [6] DESMET VJ,GERBER M,HOOFNAGLE JH,et al. Classification of chronic hepatitis:Diagnosis,grading and staging[J].Hepatology,1994,19(6):1513-1520. [7] ISHAK K,BAPTISTA A,BIANCHI L,et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol,1995,22(6):696-699. [8] GOODMAN ZD. Grading and staging systems for inflammation and fibrosis in chronic liver diseases[J]. J Hepatol,2007,47(4):598-607. [9] BEDOSSA P,POYNARD T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group[J]. Hepatology,1996,24(2):289-293. [10] TIAN AP,YANG YF. A comparative analysis of pathological grading and staging systems for chronic hepatitis[J]. J Clin Hepatol,2018,34(11):2271-2277.(in Chinese)田爱平,杨永峰.慢性肝炎病理学分级分期评分系统比较[J].临床肝胆病杂志,2018,34(11):2271-2277. [11] SUN Y,ZHOU J,WANG L,et al. New classification of liver biopsy assessment for fibrosis in chronic hepatitis B patients before and after treatment[J]. Hepatology,2017,65(5):1438-1450. [12] WANG Y,VINCENT R,YANG J,et al. Dual-photon microscopy-based quantitation of fibrosis-related parameters(qFP)to model disease progression in steatohepatitis[J]. Hepatology,2017,65(6):1891-1903. [13] ROUSSELET MC,MICHALAK S,DUPRF,et al. Sources of variability in histological scoring of chronic viral hepatitis[J].Hepatology,2005,41(2):257-264. [14] FONTANA RJ,LOK AS. Noninvasive monitoring of patients with chronic hepatitis C[J]. Hepatology,2002,36(5 Suppl1):s57-s64. [15] POYNARD T,MUNTEANU M,IMBERT-BISMUT F,et al.Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C[J]. Clin Chem,2004,50(8):1344-1355. [16] Chinese Portal Hypertension Diagnosis and Monitoring Study Group(CHESS); Minimally Invasive Intervention Collaborative Group,Chinese Society of Gastroenterology; Emergency Intervention Committee,Chinese College of Interventionalists,et al. Consensus on clinical application of hepatic venous pressure gradient in China(2018)[J]. J Clin Hepatol,2018,34(12):2526-2536.(in Chinese)中国门静脉高压诊断与监测研究组(CHESS),中华医学会消化病学分会微创介入协作组,中国医师协会介入医师分会急诊介入专业委员会,等.中国肝静脉压力梯度临床应用专家共识(2018版)[J].临床肝胆病杂志,2018,34(12):2526-2536. [17] BOSCH J,ABRALDES JG,BERZIGOTTI A,et al. The clinical use of HVPG measurements in chronic liver disease[J]. Nat Rev Gastroenterol Hepatol,2009,6(10):573-582. [18] QI X,BERZIGOTTI A,CARDENAS A,et al. Emerging noninvasive approaches for diagnosis and monitoring of portal hypertension[J]. Lancet Gastroenterol Hepatol,2018,3(10):708-719. [19] ZHANG QD,LU LG. Present situation on non-invasive assessment of liver fibrosis/cirrhosis[J]. Chin J Hepatol,2018,26(5):325-327.(in Chinese)张启迪,陆伦根.无创肝纤维化/肝硬化评估技术的现状[J].中华肝脏病杂志,2018,26(5):325-327. [20] BELLAN M,CASTELLO LM,PIRISI M. Candidate biomarkers of liver fibrosis:A concise,pathophysiology-oriented review[J]. J Clin Transl Hepatol,2018,6(3):317-325. [21] DONG XQ,WU Z,ZHAO H,et al. Evaluation and comparison of thirty noninvasive models for diagnosing liver fibrosis in chinese hepatitis B patients[J]. J Viral Hepat,2019,26(2):297-307. [22] 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. [23] 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. [24] 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. [25] 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. [26] CALS P,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. [27] ZENG MD,LU LG,MAO YM,et al. Prediction of significant fibrosis in HBe Ag-positive patients with chronic hepatitis B by a noninvasive model[J]. Hepatology,2005,42(6):1437-1445. [28] 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. [29] HUI AY,CHAN HL,WONG VW,et al. Identification of chronic hepatitis B patients without significant liver fibrosis by a simple noninvasive predictive model[J]. Am J Gastroenterol,2005,100(3):616-623. [30] ROSENBERG WM,VOELKER M,THIEL R,et al. Serum markers detect the presence of liver fibrosis:A cohort study[J].Gastroenterology,2004,127(6):1704-1713. [31] SUD A,HUI JM,FARRELL GC,et al. Improved prediction of fibrosis in chronic hepatitis C using measures of insulin resistance in a probability index[J]. Hepatology,2004,39(5):1239-1247. [32] SINGH S,MUIR AJ,DIETERICH DT,et al. American Gastroenterological Association Institute technical review on the role of elastography in chronic liver diseases[J]. Gastroenterology,2017,152(6):1544-1577. [33] LIN YS. Ultrasound evaluation of liver fibrosis[J]. J Med Ultrasound,2017,25(3):127-129. [34] HOROWITZ JM,VENKATESH SK,EHMAN RL,et al. Evaluation of hepatic fibrosis:A review from the society of abdominal radiology disease focus panel[J]. Abdom Radiol(NY),2017,42(8):2037-2053. [35] LIM JK,FLAMM SL,SINGH S,et al. American Gastroenterological Association institute guideline on the role of elastography in the evaluation of liver fibrosis[J]. Gastroenterology,2017,152(6):1536-1543. [36] Foundation for Hepatitis Prevention and Control; Chinese Society of Infectious Disease and Chinese Society of Hepatology,Chinese Medical Association. Consensus on clinical application of transient elastography detecting liver fibrosis:A 2018update[J]. Chin J Hepatol,2019,27(3):182-191.(in Chinese)中国肝炎防治基金会,中华医学会感染病学分会,中华医学会肝病学分会和中国研究型医院学会肝病专业委员会.瞬时弹性成像技术诊断肝纤维化专家共识(2018年更新版)[J].中华肝脏病杂志,2019,27(3):182-191. [37] JIA J,HOU J,DING H,et al. Transient elastography compared to serum markers to predict liver fibrosis in a cohort of Chinese patients with chronic hepatitis B[J]. J Gastroenterol Hepatol,2015,30(4):756-762. [38] CHEN YP,LIANG XE,DAI L,et al. Improving transient elastography performance for detecting hepatitis B cirrhosis[J].Dig Liver Dis,2012,44(1):61-66. [39] CHEN YP,LIANG XE,ZHANG Q,et al. Larger biopsies evaluation of transient elastography for detecting advanced fibrosis in patients with compensated chronic hepatitis B[J]. J Gastroenterol Hepatol,2012,27(7):1219-1226. [40] LIANG X,XIE Q,TAN D,et al. Interpretation of liver stiffness measurement-based approach for the monitoring of hepatitis B patients with antiviral therapy:A 2-year prospective study[J]. J Viral Hepat,2018,25(3):296-305. [41] DONG XQ,WU Z,LI J,et al. Declining in liver stiffness cannot indicate fibrosis regression in patients with chronic hepatitis B:A 78-week prospective study[J]. J Gastroenterol Hepatol,2019,34(4):755-763. [42] AFDHAL NH,BACON BR,PATEL K,et al. Accuracy of fibroscan,compared with histology,in analysis of liver fibrosis in patients with hepatitis B or C:A United States multicenter study[J]. Clin Gastroenterol Hepatol,2015,13(4):772-779. e1-3. [43] SEO YS,KIM MY,KIM SU,et al. Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis:A multicentre,retrospective study[J]. Liver Int,2015,35(10):2246-2255. [44] CASSINOTTO C,BOURSIER J,de LDINGHEN V,et al. Liver stiffness in nonalcoholic fatty liver disease:A comparison of supersonic shear imaging,FibroScan,and ARFI with liver biopsy[J]. Hepatology,2016,63(6):1817-1827. [45] SIDDIQUI MS,VUPPALANCHI R,VAN NATTA ML,et al. Vibration-controlled transient elastography to assess fibrosis and steatosis in patients with nonalcoholic fatty liver disease[J]. Clin Gastroenterol Hepatol,2019,17(1):156-163. e2. [46] THIELE M,DETLEFSEN S,SEVELSTED MLLER L,et al.Transient and 2-dimensional shear-wave elastography provide comparable assessment of alcoholic liver fibrosis and cirrhosis[J]. Gastroenterology,2016,150(1):123-133. [47] WU S,YANG Z,ZHOU J,et al. Systematic review:Diagnostic accuracy of non-invasive tests for staging liver fibrosis in autoimmune hepatitis[J]. Hepatol Int,2019,13(1):91-101. [48] SINGH S,VENKATESH SK,WANG Z,et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis:A systematic review and meta-analysis of individual participant data[J]. Clin Gastroenterol Hepatol,2015,13(3):440-451. e6. [49] IMAJO K,KESSOKU T,HONDA Y,et al. Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography[J]. Gastroenterology,2016,150(3):626-637. e7. [50] YOON YJ,FRIEDMAN SL,LEE YA. Antifibrotic therapies:Where are we now?[J]. Semin Liver Dis,2016,36(1):87-98. [51] MEHAL WZ,SCHUPPAN D. Antifibrotic therapies in the liver[J]. Semin Liver Dis,2015,35(2):184-198. [52] CAMPANA L,IREDALE JP. Regression of liver fibrosis[J].Semin Liver Dis,2017,37(1):1-10. [53] MARCELLIN P,GANE E,BUTI M,et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B:A 5-year open-label follow-up study[J].Lancet,2013,381(9865):468-475. [54] RAMACHANDRAN P,HENDERSON NC. Antifibrotics in chronic liver disease:Tractable targets and translational challenges[J]. Lancet Gastroenterol Hepatol,2016,1(4):328-340. [55] WEISKIRCHEN R. Hepatoprotective and anti-fibrotic agents:It’s time to take the next step[J]. Front Pharmacol,2015,6:303. [56] TACKE F,WEISKIRCHEN R. An update on the recent advances in antifibrotic therapy[J]. Expert Rev Gastroenterol Hepatol,2018,12(11):1143-1152. [57] Chinese Society of Infectious Diseases Chinese Medical Association,Expert Committee for Prevenaon and Management of Liver Inflammation. Consensus statement by the expert committee for prevention and management of liver inflammation in China[J]. Chin J Hepatol,2014,22(2):94-103.(in Chinese)中华医学会感染病学分会,肝脏炎症及其防治专家共识专家委员会.肝脏炎症及其防治专家共识[J].中华肝脏病杂志,2014,22(2):94-103. [58] WAH KHEONG C,NIK MUSTAPHA NR,MAHADEVA S. A randomized trial of silymarin for the treatment of nonalcoholicsteatohepatitis[J]. Clin Gastroenterol Hepatol,2017,15(12):1940-1949. e8. [59] GOEL A,KIM WR. Natural History of primary biliary cholangitis in the ursodeoxycholic acid era:Role of scoring systems[J].Clin Liver Dis,2018,22(3):563-578. [60] NEUSCHWANDER-TETRI BA,LOOMBA R,SANYAL AJ,et al. Farnesoid X nuclear receptor ligand obeticholic acid for non-cirrhotic,non-alcoholic steatohepatitis(FLINT):A multicentre,randomised,placebo-controlled trial[J]. Lancet,2015,385(9972):956-965. [61] LIEBER CS,DECARLI LM,MAK KM,et al. Attenuation of alcohol-induced hepatic fibrosis by polyunsaturated lecithin[J]. Hepatology,1990,12(6):1390-1398. [62] YANG RH,LI Q,CHEN W. Efficacy and safety of Fuzhenghuayu capsule for treating liver fibrosis in patients with chronic hepatitis B:A Meta-analysis[J]. Chin J Hepatol,2015,23(4):295-296.(in Chinese)杨瑞华,李芹,陈玮.扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化疗效的Meta分析[J].中华肝脏病杂志,2015,23(4):295-296. [63] MIAO L,YANG WN,DONG XQ,et al. Combined anluohuaxianwan and entecavir treatment significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection[J]. Chin J Hepatol,2019,27(7):521-526.(in Chinese)苗亮,杨婉娜,董晓琴,等.安络化纤丸联合恩替卡韦治疗可显著提高慢性乙型肝炎病毒感染者肝纤维化的改善率[J].中华肝脏病杂志,2019,27(7):521-526. [64] LIN W,LIU XJ,WEI N,et al. Systematic review of therapeutic effects of Fufang Biejia Ruangan Tablet on hepatic fibrosis[J]. Chin J Gastroenterol Hepatol,2007,16(1):69-72.(in Chinese)蔺武,刘心娟,魏南,等.复方鳖甲软肝片抗肝纤维化疗效的系统评价[J].胃肠病学和肝病学杂志,2007,16(1):69-72. [65] YUE HY,YIN C,HOU JL,et al. Hepatocyte nuclear factor4alpha attenuates hepatic fibrosis in rats[J]. Gut,2010,59(2):236-246. [66] LEE YA,WALLACE MC,FRIEDMAN SL. Pathobiology of liver fibrosis:A translational success story[J]. Gut,2015,64(5):830-841. [67] TOROK NJ,DRANOFF JA,SCHUPPAN D,et al. Strategies and endpoints of antifibrotic drug trials:Summary and recommendations from the AASLD Emerging Trends Conference,Chicago,June 2014[J]. Hepatology,2015,62(2):627-634. [68] WANG Y,LIANG X,YANG J,et al. Improved performance of quantitative collagen parameters versus standard histology in longitudinal assessment of nonadvanced liver fibrosis for chronic hepatitis B[J]. J Viral Hepat,2018,25(5):598-607.
本文二维码
计量
- 文章访问数: 1754
- HTML全文浏览量: 125
- PDF下载量: 1243
- 被引次数: 0