肝活检在非酒精性脂肪性肝病诊断和临床试验中的价值

葛启超; 陆伦根

doi:10.12449/JCH241124

肝活检在非酒精性脂肪性肝病诊断和临床试验中的价值

DOI: 10.12449/JCH241124

葛启超,
陆伦根^, ,

上海交通大学医学院附属第一人民医院消化科，上海 200080

基金项目:

国家自然科学基金面上项目 (82170620)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：葛启超负责收集资料，拟定思路，撰写论文；陆伦根负责课题设计，指导撰写文章并最后定稿。

详细信息

通信作者:
陆伦根， lungenlu1965@163.com （ORCID： 0000-0002-1533-4068）

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出版历程
- 收稿日期: 2024-03-05
- 录用日期: 2024-04-19
- 出版日期: 2024-11-25

Value of liver biopsy in the diagnosis and clinical trial of non-alcoholic fatty liver disease

Qichao GE,
Lungen LU^{,
,}

Department of Gastroenterology，Shanghai General Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 200080，China

Research funding:

General Project of National Natural Science Foundation of China (82170620)

More Information

Corresponding author: LU Lungen， lungenlu1965@163.com （ORCID： 0000-0002-1533-4068）

摘要

摘要: 非酒精性脂肪性肝病（NAFLD）构成一系列以不同程度的肝细胞损伤、脂肪积聚、炎症和纤维化为特征的组织学病变。目前，肝活检被认为是评估肝脂肪变性、炎症程度和纤维化的“金标准”，同时也是NAFLD精准分级的基石。本文就肝活检在NAFLD相关临床诊断、分期及临床试验中的应用价值作一综述。
- 非酒精性脂肪性肝病 /
- 活组织检查，针吸 /
- 诊断 /
- 临床试验
Abstract: Non-alcoholic fatty liver disease （NAFLD） constitutes a series of histological lesions characterized by varying degrees of hepatocyte damage， fat accumulation， inflammation， and fibrosis. Currently， liver biopsy is considered the “gold standard” for evaluating the degree of hepatic steatosis， inflammation， and fibrosis， and it also serves as the cornerstone for accurate grading of NAFLD. This article reviews the value and application of liver biopsy in the clinical diagnosis， staging， and clinical trials of NAFLD.
- Non-alcoholic Fatty Liver Disease /
- Biopsy， Needle /
- Diagnosis /
- Clinical Trial

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表 1 NAFLD的CRN诊断策略

Table 1. Diagnostic categories for nonalcoholic fatty liver disease as used by nonalcoholic steatohepatitis CRN

分类	定义	纤维化
非NAFLD	<5%脂肪变性	没有或存在任何程度的纤维化
NAFL，非NASH	≥5%脂肪变性伴或不伴小叶和静脉炎症	没有或存在任何程度的纤维化
交界性脂肪性肝炎肝小叶3区/1区	符合大部分但非所有脂肪性肝炎的标准（可主要累及小叶3区/1区）	没有或存在任何程度的纤维化
确定的脂肪性肝炎	符合所有脂肪性肝炎标准（脂肪变性、气球样变、小叶炎症）	没有或存在任何程度的纤维化

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