脂肪性肝病诊疗规范化的专家建议(2019年修订版)

中国研究型医院学会肝病专业委员会; 中国医师协会脂肪性肝病专家委员会; 中华医学会肝病学分会脂肪肝与酒精性肝病学组; 中华医学会内分泌学分会肝病与代谢学组

doi:10.3969/j.issn.1001-5256.2019.11.007

脂肪性肝病诊疗规范化的专家建议(2019年修订版)

DOI: 10.3969/j.issn.1001-5256.2019.11.007

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中图分类号: R575.5
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出版历程
- 出版日期: 2019-11-20

Expert recommendations on standardized diagnosis and treatment for fatty liver disease (2019 revised edition)

Committee of Hepatology, Chinese Research Hospital Association,
Fatty Liver Expert Committee, Chinese Medical Doctor Association,
National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology,
National Workshop on Liver and Metabolism, Chinese Society of Endocrinology, Chinese Medical Association

摘要

摘要:
目前,非酒精性脂肪性肝病(NAFLD)已成为我国最常见的慢性肝病。本建议从以下5个方面对NAFLD的规范化诊断和治疗进行了修订:(1)诊治中心/专病门诊的组织架构及功能;(2)筛查和评估:包括筛查对象、初步评估、病因筛查、非酒精性脂肪性肝炎和进展性肝纤维化的无创诊断、肝活组织病理学检查以及代谢紊乱和心血管风险评估等;(3)临床处理包括生活方式(饮食运动减重)调整,合并糖脂代谢紊乱、高血压等特殊人群的处理以及脂肪性肝炎和肝纤维化的药物选择;(4)特殊人群的管理包括儿童、妊娠和哺乳期妇女、合并酒精性肝病、慢性HBV和(或) HCV感染以及合并自身免疫现象等;(5)监测与随访。本建议旨在优化NAFLD患者的管理流程,指导临床医生制订更为合理的诊疗决策。
- 脂肪肝 /
- 代谢综合征 /
- 酒精中毒 /
- 诊断 /
- 治疗学 /
- 共识
Abstract:
Nonalcoholic fatty liver disease( NAFLD) is the most common liver disease in China. To provide evidence-based and updated practical recommendations for clinician,this expert recommendations have updated the diagnosis and treatment of NAFLD in five aspects as follows:( 1) the framework of NAFLD treatment centre or clinic;( 2) screening and evaluation: who should be screened,initial evaluation items,non-invasive assessment of steatohepatitis and advanced fibrosis,when to obtain a liver biopsy in patients with NAFLD,and other metabolic disorders and cardiovascular risk assessment;( 3) managements of patient with NAFLD: lifestyle intervention( dietary,exercise and weight loss),drug treating metabolic co-morbidities such as hyperlipidemia,type 2 diabetes mellitus and hypertension,and steatohepatitis and fibrosis;( 4) management of special populations with NAFLD: children,pregnant or lactating women,patients co-existence with alcoholic liver disease,chronic HBV and/or HCV infection,and autoimmune disorders;( 5) monitoring and follow-up. This consensus aims to modify the optimizing management process and guide physicians make correct and reasonable decisions in the diagnosis and treatment for patients with NAFLD.
- fatty liver /
- metabolic syndrome /
- alcoholism /
- diagnosis /
- therapeutics /
- consensus

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参考文献(25)

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