肝纤维化的实用临床方法。

StephenW

Singapore Med J. 2018 Dec;59(12):628-633. doi: 10.11622/smedj.2018145.
A practical clinical approach to liver fibrosis.
Kumar R1, Teo EK1, How CH2,3, Wong TY4, Ang TL1.
Author information

1
    Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.
2
    Care and Health Integration, Changi General Hospital, Singapore.
3
    Family Medicine Academic Clinical Programme, SingHealth Duke-NUS Academic Medical Centre, Singapore.
4
    Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore.

Abstract

Liver fibrosis is a slow, insidious process involving accumulation of extracellular matrix protein in the liver. The stage of liver fibrosis in chronic liver disease (CLD) determines overall morbidity and mortality; the higher the stage, the worse the prognosis. Noninvasive composite scores can be used to determine whether patients with CLD have significant or advanced fibrosis. Patients with low composite scores can be safely followed up in primary care with periodic reassessment. Those with higher scores should be referred to a specialist. As the epidemic of diabetes mellitus, obesity and non-alcoholic fatty liver diseases is rising, CLD is becoming more prevalent. Easy-to-use fibrosis assessment composite scores can identify patients with minimal or advanced fibrosis, and should be an integral part of decision-making. Patients with cirrhosis, high composite scores, chronic hepatitis B with elevated alanine aminotransferase and aspartate aminotransferase, or deranged liver panel of uncertain aetiology should be referred to a specialist.

Copyright: © Singapore Medical Association.
KEYWORDS:

chronic liver disease; fibrosis assessment; noninvasive composite scores

PMID:
    30631885
DOI:
    10.11622/smedj.2018145

StephenW

新加坡Med J. 2018年12月; 59（12）：628-633。 doi：10.11622 / smedj.2018145。
肝纤维化的实用临床方法。
Kumar R1，Teo EK1，CH2,3，Wong TY4，Ang TL1。
作者信息

1
    新加坡樟宜综合医院消化内科和肝病学系。
2
    新加坡樟宜综合医院护理与健康整合。
3
    家庭医学学术临床项目，SingHealth Duke-NUS学术医疗中心，新加坡。
4
    新加坡Tan Tock Seng医院继续和社区护理系。

抽象

肝纤维化是一个缓慢，阴险的过程，涉及肝脏中细胞外基质蛋白的积累。慢性肝病（CLD）的肝纤维化阶段决定了总体发病率和死亡率;阶段越高，预后越差。无创复合评分可用于确定CLD患者是否具有显着或晚期纤维化。综合评分低的患者可以在初级保健中安全随访，并定期进行重新评估。分数较高的人应该转介给专科医生。随着糖尿病的流行，肥胖和非酒精性脂肪肝疾病正在上升，CLD正变得越来越普遍。易于使用的纤维化评估综合评分可以识别纤维化最小或晚期的患者，并且应该是决策的一个组成部分。肝硬化，高综合评分，丙氨酸氨基转移酶和天冬氨酸氨基转移酶升高的慢性乙型肝炎患者，或病因不明的肝脏病变组应转诊给专科医生。

版权所有：©新加坡医学会。
关键词：

慢性肝病;纤维化评估;无创综合评分

结论：
    30631885
DOI：
    10.11622 / smedj.2018145