The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease.
The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease.
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DOI：
10.1016/j.cld.2004.04.004
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发表时间：
2004-08-01
影响因子：
5.1
通讯作者：
McCullough, Arthur J
中科院分区：
文献类型：
--
作者：
McCullough, Arthur J
非酒精性脂肪性肝病（NAFLD）已成为美国最常见的慢性肝病。NAFLD的组织学表现多样，从单纯的肝脂肪变性到非酒精性脂肪性肝炎（NASH），NASH是NAFLD最严重的形式。NASH是一种进行性纤维化疾病，在10年期间，肝硬化和肝脏相关死亡的发生率分别高达20%和12%。与NASH相关的肝硬化还可发展为亚急性肝衰竭，进展为肝细胞癌，并在移植后复发。相比之下，单纯的脂肪变性临床病程较为良性，尽管这些患者中有3%会进展为肝硬化。纤维化的主要危险因素包括糖尿病或肥胖、天冬氨酸氨基转移酶/丙氨酸氨基转移酶比值大于1、年龄大于50岁以及肝脏组织学情况。
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease in the United States. The histologic spectrum of NAFLD ranges from steatosis liver alone to nonalcoholic steatohepatitis (NASH), which is the most serious form of NAFLD. NASH is a progressive fibrotic disease, in which cirrhosis and liver-related death occur in up to 20% and 12%, respectively, over a 10-year period. NASH-associated cirrhosis also can develop into subacute liver failure, progress to hepatocellular carcinoma, and reoccur post-transplantation. In contrast, steatosis alone has a more benign clinical course, although progression to cirrhosis has occurred in 3% of these patients. The major risk factors for fibrosis include diabetes or obesity, an aspartate aminotransferase/alanine aminotransferase ratio of greater than 1, age older than 50, and hepatic histology.