非酒精性脂肪性肝病:一种未被认可的密码性肝硬化病的原因
Jeanne M Clark1, Anna Mae Diehl
1Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
JAMA
|June 12, 2003
概括
非酒精性脂肪肝 (NAFLD) 是密码性肝硬化的主要原因,但诊断往往会延迟,增加死亡风险. 早期发现和管理NAFLD相关的肝硬化对于更好的患者结果至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
背景情况:
- 密码性肝硬化是美国肝病发病率和死亡率的重要原因.
- 非酒精性脂肪性肝病 (NAFLD) 越来越多地被确定为密码性肝硬化的主要原因.
研究的目的:
- 为突出诊断NAFLD二次性肝硬化所面临的挑战.
- 强调及时诊断和管理NAFLD相关肝硬化的重要性.
- 介绍一个案例,说明延迟诊断及其严重后果.
主要方法:
- 一个53岁的男性的病例研究介绍,患有肝脏胸水和胸.
- 对NAFLD和肝硬化诊断方法的审查.
- 讨论目前对NAFLD的管理建议.
主要成果:
- 患者表现出肝脏水胸炎和炎,揭示了由于NAFLD导致的底层肝硬化.
- 非侵入性方法可以表明NAFLD,但肝活检是诊断肝硬化和评估疾病严重程度的决定性.
- 氨基转移酶和成像可能无法检测临床上沉默的,晚期肝病.
结论:
- 及时诊断NAFLD诱导的肝硬化是关键的,但往往会延迟.
- 肝活检对于准确诊断和NAFLD相关肝病的分期至关重要.
- 管理策略包括避免肝毒素和控制相关的代谢状况,如高甘油三血症和2型糖尿病.
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