Noninvasive assessment of liver fibrosis in patients with chronic hepatitis B
Noninvasive assessment of liver fibrosis in patients with chronic hepatitis B
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DOI：
10.3748/wjg.v20.i34.12031
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发表时间：
2014-09-14
影响因子：
4.3
通讯作者：
Kawada, Norifumi
中科院分区：
文献类型：
--
作者：
Enomoto, Masaru;Morikawa, Hiroyasu;Kawada, Norifumi
B型肝炎病毒感染是世界范围内的一个重要健康问题：它影响超过3.5亿人，是肝脏相关疾病的主要原因，每年造成100万人死亡。肝纤维化是细胞外基质成分在肝脏中积累的结果。肝纤维化的准确诊断对于慢性肝病的管理至关重要。肝活检被认为是诊断疾病、分级坏死性炎症活动和分期纤维化的金标准。然而，肝活检不适合重复评估，因为它是侵入性的，可能导致严重的并发症，包括死亡。已经引入了几种非侵入性评估用于评估肝纤维化：血清生物标志物、组合指数或评分以及成像技术，包括瞬时弹性成像、声辐射力脉冲、实时组织弹性成像和磁共振弹性成像。现就慢性B型肝炎肝纤维化无创性评估的最新进展作一综述。大多数肝纤维化的无创性评估首先在慢性丙型肝炎患者中得到验证，然后在慢性B型肝炎患者中得到验证。建立一个非侵入性的评估肝纤维化是迫切需要的，以帮助管理这一慢性肝病的主要原因。(C)2014百世登出版集团股份有限公司All rights reserved.
Infection with hepatitis B virus is an important health problem worldwide: it affects more than 350 million people and is a leading cause of liver-related morbidity, accounting for 1 million deaths annually. Hepatic fibrosis is a consequence of the accumulation of extracellular matrix components in the liver. An accurate diagnosis of liver fibrosis is essential for the management of chronic liver disease. Liver biopsy has been considered the gold standard for diagnosing disease, grading necroinflammatory activity, and staging fibrosis. However, liver biopsy is unsuitable for repeated evaluations because it is invasive and can cause major complications, including death. Several noninvasive evaluations have been introduced for the assessment of liver fibrosis: serum biomarkers, combined indices or scores, and imaging techniques including transient elastography, acoustic radiation force impulse, real-time tissue elastography, and magnetic resonance elastography. Here, we review the recent progress of noninvasive assessment of liver fibrosis in patients with chronic hepatitis B. Most noninvasive evaluations for liver fibrosis have been validated first in patients with chronic hepatitis C, and later in those with chronic hepatitis B. The establishment of a noninvasive assessment of liver fibrosis is urgently needed to aid in the management of this leading cause of chronic liver disease. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.