血清学指标诊断肝纤维化的研究进展

Research Progress of Serological Index in Diagnosis of Liver Fibrosis

摘要: 不同病因所致的慢性肝病(chronic Liver Disease，CLD)正在逐渐危害我们人类的生命健康，如果不及时进行干预，最终会引起肝脏纤维化、肝硬化、肝癌甚至死亡。肝纤维化的形成和积累是导致发展性肝病的常见途径；所以，临床上早期发现、早期诊断肝纤维化对于临床实践中患者的管理至关重要。目前临床上诊断肝纤维化的“金标准”是肝活检，然而“金标准”也并非完美无缺，存在一定风险，比如：侵袭性、采样误差、并发症(出血、感染等)、重复性差、不利于动态观察病情变化等。为了更好的避开这些弊端，减轻患者的痛苦、经济负担、社会负担以及改善患者的生活质量，一些易于计算的血清学诊断模型应运而生，给患者带来了福音，也给临床医生带来了极大的便利，便于动态观察纤维化程度，动态观察患者病情变化。迄今为止已有肝纤4项、数个无创诊断模型、蛋白质等血清学指标在慢性肝病、肝纤维化患者中得到评价。本文就血清学无创指标诊断肝纤维化的研究进展做一综述。

Abstract: Chronic liver disease (CLD) caused by different etiologies is gradually endangering the life and health of human beings. Without timely intervention, it will eventually cause liver fibrosis, cirrhosis, liver cancer and even death. The formation and accumulation of liver fibrosis is a common pathway leading to developmental liver disease. Therefore, early detection and diagnosis of liver fibrosis in clinical practice is of great importance to the management of patients. At present, the “gold standard” for clinical diagnosis of liver fibrosis is liver biopsy. However, the “gold standard” is not perfect, and there are certain risks, such as: invasiveness, sampling error, complications (bleeding, infection, etc.), poor repeatability, not conducive to dynamic observation of disease changes, etc. In order to avoid these disadvantages, the patient's pain, to reduce the economic burden and social burden and improve the patient’s quality of life, some is easy to calculate the serological diagnosis model arises at the historic moment, brought the Gospel to patients, also has brought great convenience for clinicians, easy to dynamically observe the degree of fibrosis, dynamic observation of patients condition change. So far, four hepatic fibrosis items, several non-invasive diagnostic models, protein and other serological indicators have been evaluated in patients with chronic liver disease and liver fibrosis. This article reviews the research progress of serological noninvasive indexes in the diagnosis of liver fibrosis.