在初级保健中评估与代谢功能障碍相关的脂肪肝疾病:一个共识声明摘要
Leon A Adams1,2, William W Kemp3, Kate R Muller4
1University of Western Australia, Perth, WA.
The Medical journal of Australia
|July 28, 2025
概括
建议对患有2型糖尿病或肥胖的成年人进行代谢功能障碍相关的脂肪肝疾病 (MAFLD) 查. 使用超声波和FIB-4指数的早期评估有助于识别和管理MAFLD及其并发症.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 主要护理医学 医疗保健
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 与代谢功能障碍相关的脂肪肝疾病 (MAFLD) 是一个普遍的疾病.
- 这份共识声明摘要提供了基于证据的建议,用于MAFLD在初级保健机构的评估和监测.
研究的目的:
- 为在初级保健中识别,评估和监测患有MAFLD的成年人提供准则.
- 概述MAFLD患者的风险分层策略.
主要方法:
- 建议是基于基于证据的共识声明.
- 使用超声波来评估肝脏肥胖症.
- 使用纤维化-4 (FIB-4) 指数进行晚期肝纤维化风险评估.
- 建议在必要时进行二线评估,如肝弹性图或直接肝纤维化血清测试.
主要成果:
- 患有2型糖尿病,肥胖或多种代谢风险因素的成年人应接受MAFLD查.
- 常见的并发病包括心血管疾病,慢性病和阻塞性睡眠呼吸暂停.
- 氨基转移酶水平升高需要对乙型肝炎,乙型肝炎和铁过载进行检测.
- 低FIB-4分数 (<1.3) 对晚期纤维化有很高的负预测值.
结论:
- 对有风险的人来说,MAFLD查至关重要.
- 综合性评估应包括并发症和肝硬化症的替代原因.
- 使用FIB-4指数进行风险分层指导进一步调查和转介.
- 建议定期监测代谢参数和肝纤维化.
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