肝纤维化的临床研究进展.pdfVIP

胃肠病学2007年第 l2卷第l2期 肝纤维化的临床研究进展 陆伦根 上海交通大学医学院附属仁济医院消化内科 上海市消化疾病研究所(200001) 摘要 肝纤维化是所有慢性肝病的共同特征，多种因素参与其发生和发展。各种因素所致的肝纤维化的进程不 同，但目前对其自然史的认识尚不全面。肝纤维化的非创伤性诊断临床实际应用尚有一定距离。对临床、生化和影像 等指标进行综合评估应是今后努力的方向。肝纤维化和肝硬化可出现逆转和消失完全改变了对其治疗的认识。目前 尚无有效的肝纤维化治疗药物，最有效的治疗方法仍是病因治疗。肝纤维化药物治疗开发存在不少困难，但前景 广阔。 关键词 肝纤维化； 自然史； 诊断，非创伤； 研究 Advances in CIL,dcal Research of Hepatic Fibrosis LU Lungen．Department of Gastroenterology,Renji Hospital, Shanghai Jiaotong University School ofMedicine Shanghai Institute ofDigestive D~eme，Shanghai(2oooox) Abstract Hepatic fibrosis is the common characteristic of chronic liver diseases with various etiologies， and many factors are involved in its development． The courses of hepatic fibrosis caused by various factors are different， and the recognition of its natural history is not yet well known． The actual application of noninvasive methods for the diagnosis of hepatic fibrosis has some gaps， and comprehensive evaluation of clinical， biochemical and imaging markers of hepatic fibrosis should be the goal for further studies in the future． Reversion and disappearance of hepatic fibrosis and cirrhosis may change the recognition of treatment． At present， there is no effective drug for hepatic fibrosis， and therapy on the etiologies is still the most effective measure． Although there are many difficulties in the development of drug ther~y for hepatic fibrosis currently，yet its prospect is promising． Key words Hepatic Fibrosis； Natural History； Diagnosis，Noninvasive； Research 肝纤维化是一种代偿修复反应，又是肝损害的 肝纤维化发生、发展过程中，细胞因子的信号转导 促进因素，这种动态演变过程是肝病慢性化的共同 极为复杂，一方面，同一条信号转导通路可被多种 特征。各种病因引起的多数慢性肝病都存在肝纤维 细胞因子激活：另一方面．同一种细胞因子也可激 化，其中25％ 40％最终发展为肝硬化直至肝癌，而 活多条信号转导通路，且细胞因子的信号转导过程 各种肝病发展为肝纤维化和肝硬化的进程与许多 受多种因