初级保健诊所中非酒精性脂肪肝的筛查

StephenW

Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic

Nov 23, 2020

Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic

Abstract:
Nonalcoholic fatty liver disease (NAFLD) is a spectrum of diseases ranging from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH) to advanced fibrosis and cirrhosis as well as liver cancer. Despite the significant morbidity associated with NAFLD, there are no global consensus guidelines to screen for liver fibrosis in patients considered high risk, including patients older than 50 years with type 2 diabetes or metabolic syndrome. Multiple therapies are currently being investigated and may soon receive regulatory approval for use in the clinic. It is suggested that patients at high risk for NAFLD be screened in the outpatient setting. This article aims to supply primary care providers (PCPs) with the knowledge and tools needed to properly evaluate a patient at high risk of developing significant liver disease from NASH. A tripartite algorithm is described to help PCPs identify patients with NAFLD using liver enzymes and abdominal ultrasound, assess the presence of advanced liver fibrosis using clinical prediction rules, and, if appropriate, determine when to refer patients to specialist care.

StephenW

初级保健诊所中非酒精性脂肪肝的筛查

2020年11月23日

初级保健诊所中非酒精性脂肪肝的筛查

抽象：
非酒精性脂肪肝疾病（NAFLD）是一系列疾病，从单纯性肝脂肪变性到非酒精性脂肪性肝炎（NASH）到晚期纤维化和肝硬化以及肝癌。尽管与NAFLD相关的发病率很高，但尚无全球共识指南来筛查被认为具有高风险的患者，包括年龄在50岁以上的2型糖尿病或代谢综合征患者。目前正在研究多种疗法，并且可能很快会获得监管部门的批准，可用于临床。建议在门诊患者中筛查NAFLD高危患者。本文旨在为初级保健提供者（PCP）提供正确评估患有NASH引起重大肝病高风险患者所需的知识和工具。描述了一种三方算法，以帮助PCP使用肝酶和腹部超声来识别NAFLD患者，使用临床预测规则评估晚期肝纤维化的存在，并在适当的情况下确定何时将患者转介至专科治疗。

StephenW

https://www.robertgish.com/blog/ ... primary-care-clinic