肝纤维化研究进展：机制、诊断与治疗

Research Progress in Hepatic Fibrosis: Mechanisms, Diagnosis and Therapy

摘要: 肝纤维化是多种慢性肝病进展为肝硬化及肝癌的关键病理过程，其核心机制为肝星状细胞(HSCs)活化及细胞外基质(ECM)异常沉积。研究表明，TGF-β1/Smad等信号通路、代谢重编程、非编码RNA及免疫细胞相互作用共同参与HSCs的调控，推动纤维化进展。流行病学上，病毒性肝炎仍为主要病因，而非酒精性脂肪性肝病相关纤维化呈上升趋势。诊断方面，非侵入性检测技术不断发展，但肝活检仍为金标准。治疗上，抗纤维化药物、中药活性成分及靶向分子治疗取得一定进展，基因编辑等新技术展现出潜在应用前景。

Abstract: Hepatic fibrosis is a critical pathological process in which various chronic liver diseases progress to liver cirrhosis and hepatocellular carcinoma. Its core mechanism lies in the activation of hepatic stellate cells and abnormal deposition of extracellular matrix. Studies have demonstrated that signaling pathways such as TGF-β1/Smad, metabolic reprogramming, non-coding RNAs, and crosstalk with immune cells are jointly involved in the regulation of HSCs, thereby promoting fibrogenesis. Epidemiologically, viral hepatitis remains the leading etiology, while fibrosis associated with non-alcoholic fatty liver disease is on the rise. In terms of diagnosis, non-invasive detection techniques have been continuously developed, yet liver biopsy is still the gold standard. In treatment, certain progress has been made in anti-fibrotic drugs, active ingredients of traditional Chinese medicine, and targeted molecular therapy, and novel technologies such as gene editing have shown promising application potential.