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儿童非酒精性脂肪性肝病的诊断进展
Research advances in the diagnosis of nonalcoholic fatty liver disease in children
文章发布日期:2017年09月07日  来源:  作者:李婧, 戚伶俐, 吴捷  点击次数:1896次  下载次数:248次

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【摘要】:非酒精性脂肪性肝病(NAFLD)已成为儿童最常见的慢性肝病之一,其临床表现缺乏特异性,目前诊断主要根据临床症状结合辅助检查。其中,血清肝脏酶谱、血脂谱、稳态模型胰岛素抵抗指数临床应用较多,而细胞角蛋白18、空腹甘油三酯血糖指数等有可能成为儿童NAFLD诊断的新指标。超声、MRI、CT等影像学检查对儿童NAFLD诊断均有局限性,但肝脏脂肪变性定量诊断技术和声辐射力脉冲弹性成像检测技术未来可能有较高应用价值。关于NAFLD的多种评分方法有待进一步研究验证。目前肝活组织检查仍为儿童NAFLD诊断的“金标准”。对儿童NAFLD最新研究进展进行总结,并对相关实验室指标及影像学检查的诊断价值加以讨论。
【Abstract】:Nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases in children. Since the clinical manifestations of NAFLD lack specificity, the diagnosis of this disease is mainly based on clinical symptoms and auxiliary examinations. Serum liver enzymes, blood lipid levels and homeostasis model assessment of insulin resistance are commonly used in clinical practice, and cytokeratin-18, triglyceride glucose index may become new markers for the diagnosis of NAFLD in children. Imaging examinations such as ultrasound, magnetic resonance imaging and computed tomography have their own limitations in the diagnosis of NAFLD in children, while controlled attenuation parameter and acoustic radiation force impulse may have a high value in future. The scoring systems for NAFLD need to be validated by clinical research. At present, liver biopsy remains the “gold standard” for the diagnosis of NAFLD in children. This article summarizes the latest research advances in NAFLD in children and discusses the diagnostic values of laboratory markers and imaging examinations.
【关键字】:脂肪肝; 诊断; 儿童; 综述
【Key words】:fatty liver; diagnosis; child; review
【引证本文】:李婧, 戚伶俐, 吴捷. 儿童非酒精性脂肪性肝病的诊断进展[J]. 临床肝胆病杂志, 2017, 33(10): 2025-2029.

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