脂肪性肝病诊疗规范化的专家建议(2019 年修订版)

2019-11-01 中国研究型医院学会 临床肝胆病杂志.2019,35(11):2426-2430.

目前,非酒精性脂肪性肝病(NAFLD)已成为我国最常见的慢性肝病。本建议从以下5 个方面对NAFLD 的规范化诊断和治疗进行了修订:(1)诊治中心/ 专病门诊的组织架构及功能;(2)筛查和评估:包括筛查对象、初步评估、病因筛查、非酒精性脂肪性肝炎和进展性肝纤维化的无创诊断、肝活组织病理学检查以及代谢紊乱和心血管风险评估等;(3)临床处理包括生活方式(饮食运动减重)调整,合并糖脂代谢紊乱、高血压等特

中文标题:

脂肪性肝病诊疗规范化的专家建议(2019 年修订版)

发布机构:

中国研究型医院学会

发布日期:

2019-11-01

简要介绍:

目前,非酒精性脂肪性肝病(NAFLD)已成为我国最常见的慢性肝病。本建议从以下5 个方面对NAFLD 的规范化诊断和治疗进行了修订:(1)诊治中心/ 专病门诊的组织架构及功能;(2)筛查和评估:包括筛查对象、初步评估、病因筛查、非酒精性脂肪性肝炎和进展性肝纤维化的无创诊断、肝活组织病理学检查以及代谢紊乱和心血管风险评估等;(3)临床处理包括生活方式(饮食运动减重)调整,合并糖脂代谢紊乱、高血压等特殊人群的处理以及脂肪性肝炎和肝纤维化的药物选择;(4)特殊人群的管理包括儿童、妊娠和哺乳期妇女、合并酒精性肝病、慢性HBV 和(或)HCV 感染以及合并自身免疫现象等;(5)监测与随访。本建议旨在优化NAFLD 患者的管理流程,指导临床医生制订更为合理的诊疗决策。

 

拓展指南:脂肪肝相关指南:

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1212322, encodeId=8a691212322fd, content=NAFLD有可能合并的其他学科的疾病阐述的很细致, beContent=null, objectType=guider, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:33:52 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1212319, encodeId=9d9c121231969, content=为脂肪肝的治疗指明了方向, beContent=null, objectType=guider, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:32:29 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967202, encodeId=0f5096e2024a, content=想学习,没积分, beContent=null, objectType=guider, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a6a95153046, createdName=jolene, createdTime=Thu May 20 12:35:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959858, encodeId=5f799598589d, content=好多文章都想看,又没积分,咋办?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:44 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959857, encodeId=b49e95985ebf, content=怎样得到更多积分?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:24 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2022-04-18 ms8000001408294061

    NAFLD有可能合并的其他学科的疾病阐述的很细致

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1212322, encodeId=8a691212322fd, content=NAFLD有可能合并的其他学科的疾病阐述的很细致, beContent=null, objectType=guider, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:33:52 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1212319, encodeId=9d9c121231969, content=为脂肪肝的治疗指明了方向, beContent=null, objectType=guider, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:32:29 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967202, encodeId=0f5096e2024a, content=想学习,没积分, beContent=null, objectType=guider, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a6a95153046, createdName=jolene, createdTime=Thu May 20 12:35:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959858, encodeId=5f799598589d, content=好多文章都想看,又没积分,咋办?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:44 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959857, encodeId=b49e95985ebf, content=怎样得到更多积分?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:24 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2022-04-18 ms8000001408294061

    为脂肪肝的治疗指明了方向

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1212322, encodeId=8a691212322fd, content=NAFLD有可能合并的其他学科的疾病阐述的很细致, beContent=null, objectType=guider, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:33:52 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1212319, encodeId=9d9c121231969, content=为脂肪肝的治疗指明了方向, beContent=null, objectType=guider, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:32:29 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967202, encodeId=0f5096e2024a, content=想学习,没积分, beContent=null, objectType=guider, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a6a95153046, createdName=jolene, createdTime=Thu May 20 12:35:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959858, encodeId=5f799598589d, content=好多文章都想看,又没积分,咋办?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:44 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959857, encodeId=b49e95985ebf, content=怎样得到更多积分?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:24 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2021-05-20 jolene

    想学习,没积分

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1212322, encodeId=8a691212322fd, content=NAFLD有可能合并的其他学科的疾病阐述的很细致, beContent=null, objectType=guider, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:33:52 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1212319, encodeId=9d9c121231969, content=为脂肪肝的治疗指明了方向, beContent=null, objectType=guider, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:32:29 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967202, encodeId=0f5096e2024a, content=想学习,没积分, beContent=null, objectType=guider, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a6a95153046, createdName=jolene, createdTime=Thu May 20 12:35:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959858, encodeId=5f799598589d, content=好多文章都想看,又没积分,咋办?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:44 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959857, encodeId=b49e95985ebf, content=怎样得到更多积分?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:24 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2021-04-23 ms3000001603573773

    好多文章都想看,又没积分,咋办?

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1212322, encodeId=8a691212322fd, content=NAFLD有可能合并的其他学科的疾病阐述的很细致, beContent=null, objectType=guider, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:33:52 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1212319, encodeId=9d9c121231969, content=为脂肪肝的治疗指明了方向, beContent=null, objectType=guider, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab606579033, createdName=ms8000001408294061, createdTime=Mon Apr 18 22:32:29 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=967202, encodeId=0f5096e2024a, content=想学习,没积分, beContent=null, objectType=guider, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a6a95153046, createdName=jolene, createdTime=Thu May 20 12:35:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959858, encodeId=5f799598589d, content=好多文章都想看,又没积分,咋办?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:44 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959857, encodeId=b49e95985ebf, content=怎样得到更多积分?, beContent=null, objectType=guider, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99e5481931, createdName=ms3000001603573773, createdTime=Fri Apr 23 18:52:24 CST 2021, time=2021-04-23, status=1, ipAttribution=)]
    2021-04-23 ms3000001603573773

    怎样得到更多积分?

    0