非酒精性脂肪性肝病:多学科临床实践方法-对现有临床实践指南的机构适应

Z. Gluvić, R. Tomasevic, Ksenija Bojović, M. Obradović, E. Isenovic
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引用次数: 2

摘要

非酒精性脂肪性肝病(NAFLD)是临床上最常见的慢性肝病之一。被认为是代谢综合征的肝脏表现。今天,肝活检仍然是NAFLD确诊和评估NAFLD可能进展为非酒精性脂肪性肝炎、纤维化、肝硬化和肝细胞癌的金标准。由于NAFLD的高患病率和侵入性诊断程序的潜在相关风险,招募患者进行肝活检是非常有意义的。然而,由于肝纤维化的存在决定了进一步的临床进程,肝活检预计将保留给那些纤维化风险增加的患者。通过使用无创工具来评估肝纤维化的存在,以及全科医生、胃肠病学家和内分泌学家之间的互动合作,肝活检招募和患者监测的质量可以显著提高。因此,肝活检招募和患者监测的质量可以显著提高。在这里,我们提出了临床实践指南,可以在NAFLD患者的日常临床实践中实施。
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Non-alcoholic fatty liver disease: a multidisciplinary clinical practice approach—the institutional adaptation to existing Clinical Practice Guidelines
Abstract Non-alcoholic fatty liver disease (NAFLD) is among the most frequently encountered chronic liver diseases in everyday clinical practice. It is considered the hepatic manifestation of metabolic syndrome. Today, liver biopsy is still the gold standard for NAFLD confirmation and assessing NAFLD's possible progression to non-alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Because of the high prevalence of NAFLD and potential associated risks of invasive diagnostic procedures, it is of great interest to recruit the patients for liver biopsy. However, as the presence of liver fibrosis determines the further clinical course, liver biopsy is expectedly reserved for those with increased fibrosis risk. The quality of liver biopsy recruitment and patient monitoring could be significantly improved by using non-invasive tools to assess liver fibrosis presence and interactive collaboration between general practitioners, gastroenterologists, and endocrinologists. As a result, the quality of liver biopsy recruitment and patients monitoring could be significantly improved. Here, we proposed clinical practice guidelines that could be implemented for everyday clinical practice in NAFLD patients.
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