收稿日期: 2025-02-21
网络出版日期: 2025-08-11
基金资助
河北省医学科学研究课题计划(20242051)
Research progress on serum⁃based assessment methods for liver fibrosis in patients with non⁃alcoholic fatty liver disease
Received date: 2025-02-21
Online published: 2025-08-11
非酒精性脂肪肝病（non-alcoholic fatty liver disease，NAFLD）已经成为全球公共卫生和医疗保健系统的一大挑战。NAFLD会出现肝脏脂肪变性、纤维化或肝硬化等病理改变，肝脏纤维化程度作为评估该疾病进展的关键指标，其重要性不言而喻。肝脏活组织检查肝纤维化的种种限制促使非侵入性生物标志物检测的应用范围逐渐拓宽。该文深入讨论4种临床上使用较广泛的纤维化血清学评分在NAFLD肝纤维化评估中的运用，并提出不同人群的推荐模型选择。详细介绍了合并其他疾病的特定评分方法、不同人群的评分方法、综合评分体系，以及相关的预后评分模型的选择标准，旨在为未来NAFLD血清学纤维化评估应用提供一定的理论基础和实践指南。
马雪颖 , 马向明 . 非酒精性脂肪肝患者肝脏纤维化血清学测评方法的研究进展[J]. 实用医学杂志, 2025 , 41(15) : 2290 -2303 . DOI: 10.3969/j.issn.1006-5725.2025.15.002
Non-alcoholic fatty liver disease （NAFLD） has become a significant global public health concern， posing substantial challenges to healthcare systems worldwide. The condition is characterized by pathological changes such as hepatic steatosis， fibrosis， and cirrhosis， with the extent of liver fibrosis serving as a key determinant in assessing disease progression. Due to the limitations of liver biopsy in evaluating fibrosis， there has been a growing emphasis on the clinical application of non-invasive biomarkers. This article provides a comprehensive review of four widely used serological fibrosis scoring systems for assessing NAFLD-related liver fibrosis and offers guidance on model selection tailored to specific patient populations. It further explores disease-specific scoring methodologies for patients with comorbidities， population-specific evaluation strategies， combined scoring systems， and criteria for selecting prognostic models. The discussion aims to provide both theoretical insights and practical recommendations for the future implementation of serological fibrosis assessment in NAFLD management.
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