{"id":109173,"date":"2019-03-14T00:00:50","date_gmt":"2019-05-17T09:29:23","guid":{"rendered":"http:\/\/www.05921.net\/index.php\/109173\/"},"modified":"2019-05-17T17:29:24","modified_gmt":"2019-05-17T09:29:24","slug":"9f2f1356ef","status":"publish","type":"post","link":"https:\/\/www.05921.net\/index.php\/109173\/","title":{"rendered":"CDE\u516c\u5f00\u5f81\u6c42 \uff1a\u300a\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\u6cbb\u7597\u836f\u7269\u4e34\u5e8a\u8bd5\u9a8c\u6280\u672f\u6307\u5bfc\u539f\u5219\uff08\u8bd5\u884c\uff09\u300b\u610f\u89c1"},"content":{"rendered":"
\n

\"CDE\u516c\u5f00\u5f81\u6c42<\/a><\/p>\n

\n
\n
\n

\u300a\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\u6cbb\u7597\u836f\u7269\u4e34\u5e8a\u8bd5\u9a8c\u6280\u672f\u6307\u5bfc\u539f\u5219\uff08\u8bd5\u884c\uff09<\/span>\u300b<\/span>\u6765\u4e86\uff01<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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\n

 \u5168\u65873935\u5b57\uff0c\u7528\u65f68\u5206\u949f<\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\u56fd\u5bb6\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40\u836f\u54c1\u5ba1\u8bc4\u4e2d\u5fc3\u516c\u5f00\u5f81\u6c42<\/span><\/span>\u300a\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\u6cbb\u7597\u836f\u7269\u4e34\u5e8a\u8bd5\u9a8c\u6280\u672f\u6307\u5bfc\u539f\u5219\uff08\u8bd5\u884c\uff09\u300b\u610f\u89c1\uff0c\u5f81\u6c42\u610f\u89c1\u65f6\u95f4\u7ef4\u6301\u4e09\u4e2a\u6708\uff0c\u5177\u4f53\u5185\u5bb9\u5982\u4e0b\uff1a<\/span><\/p>\n

\"CDE\u516c\u5f00\u5f81\u6c42<\/p>\n

<\/span><\/strong>\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\u6cbb\u7597\u836f\u7269\u4e34\u5e8a\u8bd5\u9a8c\u6280\u672f\u6307\u5bfc\u539f\u5219\uff08\u8bd5\u884c\uff09<\/span><\/strong><\/p>\n

\n
\n

\u76ee\u5f55<\/span><\/strong><\/p>\n

1.   \u9002\u7528\u8303\u56f4<\/span><\/p>\n

2. \u6982\u8ff0<\/span><\/p>\n

2.1 \u5b9a\u4e49<\/span><\/p>\n

2.2 \u6d41\u884c\u75c5\u5b66<\/span><\/p>\n

2.3 \u6cbb\u7597\u836f\u7269<\/span><\/p>\n

3. \u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1<\/span><\/p>\n

3.1 \u603b\u4f53\u8003\u8651<\/span><\/p>\n

3.1.1 \u53d7\u8bd5\u8005<\/span><\/p>\n

3.1.2 \u7ec8\u70b9\u6307\u6807\u8bc4\u4ef7<\/span><\/p>\n

3.1.3\u65b9\u6cd5\u5b66\u8003\u8651<\/span><\/p>\n

3.2 \u4e0d\u540c\u7814\u53d1\u9636\u6bb5\u5177\u4f53\u8003\u8651<\/span><\/p>\n

3.2.1 \u4e34\u5e8a\u836f\u7406\u5b66\u7814\u7a76<\/span><\/p>\n

3.2.2 \u63a2\u7d22\u6027\u4e34\u5e8a\u8bd5\u9a8c<\/span><\/p>\n

3.2.3 \u786e\u8bc1\u6027\u4e34\u5e8a\u8bd5\u9a8c<\/span><\/p>\n

3.2.4 \u786e\u8bc1\u4e34\u5e8a\u83b7\u76ca\u7684\u8bd5\u9a8c<\/span><\/p>\n

3.3 \u5b89\u5168\u6027\u8bc4\u4ef7<\/span><\/p>\n

1.     \u9002\u7528\u8303\u56f4<\/span><\/p>\n

\u672c\u6307\u5bfc\u539f\u5219\u7531\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u90e8\u95e8\u4e0e\u4e34\u5e8a\u7814\u7a76\u8005\u5171\u540c\u8ba8\u8bba\u5236\u5b9a\uff0c\u4e3a\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\uff08nonalcoholicsteatohepatitis\uff0cNASH\uff09\u6cbb\u7597\u836f\u7269\u7684\u7814\u53d1\u63d0\u4f9b\u5efa\u8bae\u3002\u672c\u6307\u5bfc\u539f\u5219\u53ea\u9488\u5bf9NASH\u4f34\u6709\u663e\u8457\u7ea4\u7ef4\u5316\u7684\u6210\u4eba\u60a3\u8005\uff0c\u4e0d\u6d89\u53caNASH\u76f8\u5173\u5931\u4ee3\u507f\u671f\u809d\u786c\u5316\u548c\u513f\u7ae5\u60a3\u8005\u3002<\/span><\/p>\n

\u672c\u6307\u5bfc\u539f\u5219\u9002\u7528\u4e8e\u5316\u5b66\u836f\u54c1\u548c\u6cbb\u7597\u7528\u751f\u7269\u5236\u54c1\u7684\u836f\u7269\u7814\u53d1\uff0c\u4ec5\u4f5c\u4e3a\u63a8\u8350\u6027\u5efa\u8bae\u3002\u5728\u5e94\u7528\u672c\u6307\u5bfc\u539f\u5219\u65f6\uff0c\u8fd8\u5e94\u540c\u65f6\u53c2\u8003\u56fd\u9645\u4eba\u7528\u836f\u54c1\u6ce8\u518c\u6280\u672f\u534f\u8c03\u4f1a\uff08TheInternational Council for Harmonization of Technical Requirements forPharmaceuticals for Human Use\uff0cICH\uff09\u548c\u5176\u4ed6\u56fd\u5185\u5916\u5df2\u53d1\u5e03\u7684\u76f8\u5173\u6280\u672f\u6307\u5bfc\u539f\u5219\u3002<\/span><\/p>\n

\u672c\u6307\u5bfc\u539f\u5219\u4f1a\u57fa\u4e8e\u79d1\u5b66\u7814\u7a76\u8fdb\u5c55\u8fdb\u4e00\u6b65\u66f4\u65b0\u3002\u9274\u4e8eNASH\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u5173\u952e\u8981\u7d20\u95ee\u9898\u7684\u8fdb\u5c55\u548c\u66f4\u65b0\u8fc5\u901f\uff0c\u672c\u6307\u5bfc\u539f\u5219\u4ec5\u4ee3\u8868\u5f53\u524d\u5efa\u8bae\u3002<\/span><\/p>\n

2. \u6982\u8ff0<\/span><\/p>\n

\u672c\u6307\u5bfc\u539f\u5219\u4e3b\u8981\u8ba8\u8bbaNASH\u6cbb\u7597\u836f\u7269\u7814\u53d1\u4e2d\u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1\u7684\u91cd\u70b9\u5173\u6ce8\u5185\u5bb9\uff0c\u4e0d\u8ba8\u8bba\u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1\u6216\u7edf\u8ba1\u5b66\u5206\u6790\u7684\u4e00\u822c\u6027\u95ee\u9898\u3002<\/span><\/p>\n

2.1 \u5b9a\u4e49<\/span><\/p>\n

\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u75c5\uff08nonalcoholic fatty liver disease\uff0cNAFLD\uff09\u662f\u4e00\u79cd\u4e0e\u80f0\u5c9b\u7d20\u62b5\u6297\uff08insulinresistance\uff0cIR\uff09\u548c\u9057\u4f20\u6613\u611f\u5bc6\u5207\u76f8\u5173\u7684\u4ee3\u8c22\u5e94\u6fc0\u6027\u809d\u810f\u635f\u4f24\uff0c\u75be\u75c5\u8c31\u5305\u62ec\u975e\u9152\u7cbe\u6027\u809d\u8102\u80aa\u53d8\uff08NonalcoholicHepaticSteatosis\uff09\u3001\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u708e\uff08NonalcoholicSteatohepatitis\uff0cNASH\uff09\u53caNASH\u76f8\u5173\u809d\u786c\u5316\u548c\u809d\u7ec6\u80de\u764c\u3002NASH\u8868\u73b0\u4e3a5%\u4ee5\u4e0a\u7684\u809d\u7ec6\u80de\u8102\u80aa\u53d8\u5408\u5e76\u5c0f\u53f6\u5185\u708e\u75c7\u548c\u809d\u7ec6\u80de\u6c14\u7403\u6837\u53d8\u6027\u3002\u4e0d\u5408\u5e76\u809d\u7ea4\u7ef4\u5316\u6216\u4ec5\u6709\u8f7b\u5ea6\u7ea4\u7ef4\u5316\uff08F0~1\uff09\u4e3a\u65e9\u671fNASH\uff1b\u5408\u5e76\u663e\u8457\u809d\u7ea4\u7ef4\u5316\u6216\u95f4\u9694\u7ea4\u7ef4\u5316\uff08F2~3\uff09\u4e3a\u7ea4\u7ef4\u5316\u6027NASH\uff1b\u5408\u5e76\u809d\u786c\u5316\uff08F4\uff09\u4e3aNASH\u809d\u786c\u5316\u3002<\/span><\/p>\n

2.2 \u6d41\u884c\u75c5\u5b66<\/span><\/p>\n

NAFLD\u662f\u5168\u7403\u6d41\u884c\u7684\u4e3b\u8981\u809d\u810f\u75be\u75c5\u4e4b\u4e00\uff0c\u6709\u6587\u732e\u62a5\u9053\uff0c\u5168\u7403\u60a3\u75c5\u7387\u4e3a25.24%\uff0895% CI\uff1a22.10-28.65\uff09\uff0c\u4e14\u60a3\u75c5\u7387\u9010\u5e74\u589e\u52a0\u3002\u5fc3\u8840\u7ba1\u75be\u75c5\u3001\u6076\u6027\u80bf\u7624\u548c\u809d\u786c\u5316\u5931\u4ee3\u507f\u662f\u5f15\u8d77NAFLD\u60a3\u8005\u6b7b\u4ea1\u7684\u5e38\u89c1\u539f\u56e0\u3002NASH\u5728\u5408\u5e76\u4ee3\u8c22\u7efc\u5408\u5f81\u30012\u578b\u7cd6\u5c3f\u75c5\u7684NAFLD \u60a3\u8005\u4e2d\u68c0\u51fa\u7387\u9ad8\u3002NASH\u662f\u5bfc\u81f4\u809d\u786c\u5316\u7684\u4e3b\u8981\u539f\u56e0\u4e4b\u4e00\uff0cNASH\u60a3\u800510~15 \u5e74\u5185\u809d\u786c\u5316\u53d1\u751f\u7387\u9ad8\u8fbe15%~25%\u3002<\/span><\/p>\n

2.3 \u6cbb\u7597\u836f\u7269<\/span><\/p>\n

\u6cbb\u7597\u76ee\u6807\uff1a\u6700\u7ec8\u76ee\u7684\u662f\u5ef6\u7f13\u3001\u963b\u6b62\u3001\u9006\u8f6cNASH\u7684\u8fdb\u5c55\uff0c\u6539\u5584\u4e34\u5e8a\u7ed3\u5c40\uff0c\u5305\u62ec\u964d\u4f4e\u809d\u786c\u5316\u53ca\u5176\u5e76\u53d1\u75c7\u7684\u53d1\u751f\uff0c\u964d\u4f4e\u809d\u79fb\u690d\u7684\u9700\u6c42\uff0c\u63d0\u9ad8\u5b58\u6d3b\u7387\uff0c\u6539\u5584\u751f\u6d3b\u8d28\u91cf\u7b49\u3002<\/span><\/p>\n

\u6cbb\u7597\u836f\u7269\uff1a\u76ee\u524d\u5c1a\u65e0\u901a\u8fc7\u968f\u673a\u5bf9\u7167\u4e34\u5e8a\u8bd5\u9a8c\u786e\u8bc1\u6709\u6548\u6027\u548c\u5b89\u5168\u6027\u7684\u6cbb\u7597\u836f\u7269\u4e0a\u5e02\u3002<\/span><\/p>\n

3. \u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1<\/span><\/p>\n

3.1 \u603b\u4f53\u8003\u8651<\/span><\/p>\n

\u836f\u7269\u7814\u53d1\u4e34\u5e8a\u8bd5\u9a8c\u7684\u8bbe\u8ba1\u57fa\u4e8e\u4e34\u5e8a\u8bd5\u9a8c\u76ee\u7684\u800c\u5b9a\u3002\u6839\u636e\u6cbb\u7597NASH\u836f\u7269\u9776\u70b9\u4e0d\u540c\uff0c\u5236\u5b9a\u4e34\u5e8a\u8bd5\u9a8c\u65b9\u6848\u3002<\/span><\/p>\n

3.1.1 \u53d7\u8bd5\u8005<\/span><\/p>\n

NASH\u8bca\u65ad\uff1a\u5c3d\u7ba1\u809d\u7ec4\u7ec7\u5b66\u68c0\u67e5\u5b58\u5728\u6709\u521b\u6027\u3001\u53d6\u6837\u548c\u8bc4\u4ef7\u8bef\u5dee\u7b49\u5c40\u9650\u6027\uff0c\u4f46\u4ecd\u7136\u662f\u76ee\u524dNASH\u8bca\u65ad\u7684\uff02\u91d1\u6807\u51c6\uff02\u3002\u5728NASH \u836f\u7269\u7814\u53d1\u4e2d\uff0c\u809d\u7ec4\u7ec7\u5b66\u68c0\u67e5\u662f\u786e\u8bc1\u6027\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u53d7\u8bd5\u8005\u8bca\u65ad\u53ca\u4e3b\u8981\u7ec8\u70b9\u7684\u8bc4\u4ef7\u6307\u6807\u3002NAFLD\/NASH\u7684\u7ec4\u7ec7\u5b66\u8bc4\u4ef7\u7cfb\u7edf\u4e3b\u8981\u5305\u62ecBrunt \u7cfb\u7edf\u3001\u7f8e\u56fdNASH \u4e34\u5e8a\u7814\u7a76\u7f51\u7edc\u8bc4\u5206\u7cfb\u7edf\uff08NASH-CRN\uff09\u3001\u6b27\u6d32\u8102\u80aa\u809d\u8fdb\u5c55\u963b\u65ad\u7ec4\u7ec7\u5b66\u8bc4\u5206\u7cfb\u7edf\uff08theFatty Liver Inhibition of Progression\uff0cFLIP-SAF\uff09\u7b49\u3002<\/span><\/p>\n

\u9f13\u52b1\u63a2\u7d22\u65e0\u521b\u6807\u5fd7\u7269\u4f5c\u4e3a\u65e9\u671f\u521d\u6b65\u7b5b\u9009NASH\u53d7\u8bd5\u8005\u7684\u65b9\u6cd5\uff0c\u5176\u4e2d\u65e2\u5305\u62ecALT\u7b49\u8840\u6e05\u751f\u5316\u6307\u6807\uff0c\u4e5f\u5305\u62ec\u8179\u90e8\u8d85\u58f0\u7b49\u7b80\u5355\u6613\u884c\u7684\u5f71\u50cf\u5b66\u6307\u6807\u3002<\/span><\/p>\n

3.1.2 \u7ec8\u70b9\u6307\u6807\u8bc4\u4ef7<\/span><\/p>\n

\u6709\u6548\u6027\u8bc4\u4ef7\u7ec8\u70b9\u5305\u62ec\u4e34\u5e8a\u7ed3\u5c40\u7ec8\u70b9\u548c\u809d\u7ec4\u7ec7\u5b66\u66ff\u4ee3\u7ec8\u70b9\uff0c\u4ee5\u53ca\u8840\u6e05\u751f\u5316\u68c0\u67e5\u3001\u5f71\u50cf\u5b66\u68c0\u67e5\u7b49\u5176\u4ed6\u63a2\u7d22\u6027\u7ec8\u70b9\u3002<\/span><\/p>\n

1\uff09\u4e34\u5e8a\u7ed3\u5c40\u8bc4\u4ef7<\/span><\/p>\n

\u5bf9\u4e8eNASH\u65e0\u809d\u786c\u5316\u7684\u60a3\u8005\uff0c\u4e34\u5e8a\u7ec8\u70b9\u5305\u62ec\u8fdb\u5c55\u81f3\u809d\u786c\u5316\u3001\u809d\u79fb\u690d\u3001\u809d\u7ec6\u80de\u764c\u6216\u809d\u75c5\u76f8\u5173\u6b7b\u4ea1\/\u5168\u56e0\u6b7b\u4ea1\u7b49\u4e8b\u4ef6\u3002<\/span><\/p>\n

\u5bf9\u4e8eNASH\u809d\u786c\u5316\u4ee3\u507f\u671f\u7684\u60a3\u8005\uff0c\u4e34\u5e8a\u7ec8\u70b9\u5305\u62ec\u51fa\u73b0\u809d\u786c\u5316\u5931\u4ee3\u507f\uff08\u8179\u6c34\u3001\u98df\u7ba1\u80c3\u5e95\u9759\u8109\u66f2\u5f20\u51fa\u8840\u6216\u809d\u6027\u8111\u75c5\u7b49\uff09\u3001\u809d\u79fb\u690d\u3001\u809d\u7ec6\u80de\u764c\u6216\u809d\u75c5\u76f8\u5173\u6b7b\u4ea1\/\u5168\u56e0\u6b7b\u4ea1\u7b49\u4e8b\u4ef6\u3002<\/span><\/p>\n

2\uff09\u809d\u7ec4\u7ec7\u75c5\u7406\u5b66\u8bc4\u4ef7<\/span><\/p>\n

\u76ee\u524d\u53ef\u63a5\u53d7\u7684\u809d\u7ec4\u7ec7\u75c5\u7406\u5b66\u66ff\u4ee3\u7ec8\u70b9\u5305\u62ec\u708e\u75c7\u6216\/\u548c\u7ea4\u7ef4\u5316\u7684\u6539\u5584\u3002<\/span><\/p>\n

\u7ec4\u7ec7\u75c5\u7406\u5b66\u8bc4\u4ef7\u8d28\u91cf\u53d7\u591a\u79cd\u56e0\u7d20\u5f71\u54cd\uff0c\u5305\u62ec\u6d3b\u68c0\u65b9\u5f0f\u3001\u6d3b\u68c0\u7c7b\u578b\uff08\u7c97\u9488\u7a7f\u523a\/\u6954\u5f62\u6d3b\u68c0\uff09\u3001\u7a7f\u523a\u90e8\u4f4d\u3001\u7a7f\u523a\u9488\u89c4\u683c\u4ee5\u53ca\u75c5\u7406\u5b66\u4e13\u5bb6\u8bc4\u4f30\u7b49\u3002\u4e3a\u4fdd\u8bc1\u7ec4\u7ec7\u5b66\u6837\u672c\u7684\u5904\u7406\u8d28\u91cf\uff0c\u8981\u6c42\u4e25\u683c\u9075\u5faa\u75c5\u7406\u6837\u672cSOP\uff08StandardOperation Procedure\uff09\u7a0b\u5e8f\u5904\u7406\u3002\u4e3a\u51cf\u5c11\u7ec4\u7ec7\u75c5\u7406\u5b66\u8bc4\u4ef7\u7684\u5dee\u5f02\uff0c\u75c5\u7406\u8bfb\u7247\u5e94\u91c7\u7528\u4e2d\u5fc3\u9605\u7247\uff0c\u5efa\u8bae\u7531\u4e24\u540d\u4ee5\u4e0a\u809d\u810f\u75c5\u7406\u4e13\u5bb6\u8fdb\u884c\u5355\u76f2\u6216\u53cc\u76f2\u8bfb\u7247\u3002<\/span><\/p>\n

3\uff09\u5f71\u50cf\u5b66\u8bc4\u4ef7<\/span><\/p>\n

\u78c1\u5171\u632f\u8d28\u5b50\u5bc6\u5ea6\u8102\u80aa\u5206\u6570\uff08MagneticResonance Imaging\u2013derived Proton Density Fat Fraction\uff0cMRI-PDFF\uff09\u53ef\u5b9a\u91cf\u8bc4\u4ef7\u809d\u810f\u8102\u80aa\u542b\u91cf\u3002\u5728\u57f9\u8bad\u548c\u826f\u597d\u8d28\u63a7\u7684\u524d\u63d0\u4e0b\uff0c\u53ef\u4ee5\u7528MRI-PDFF\u6539\u53d8\u7684\u7edd\u5bf9\u503c\u6216\u8005\u76f8\u5bf9\u767e\u5206\u6bd4\u8bc4\u4ef7\u4ee5\u809d\u8102\u80aa\u53d8\u4e3a\u6cbb\u7597\u9776\u70b9\u7684\u836f\u7269\u3002<\/span><\/p>\n

\u78c1\u5171\u632f\u5f39\u6027\u6210\u50cf\uff08MagneticResonance Elastography\uff0cMRE\uff09\u548c\u77ac\u65f6\u5f39\u6027\u6210\u50cf\uff08TransientElastography\uff0cTE\uff09\u7b49\u65e0\u521b\u6280\u672f\u53ef\u4ee5\u7528\u4e8e\u8bc4\u4ef7\u809d\u7ea4\u7ef4\u5316\u6539\u53d8\u3002\u5176\u4e2dTE\u540c\u65f6\u8054\u5408\u68c0\u6d4b\u63a7\u5236\u8870\u51cf\u53c2\u6570\uff08ControlledAttenuation Parameter\uff0cCAP\uff09\u53ef\u4ee5\u534f\u52a9\u8bc4\u4ef7\u809d\u8102\u80aa\u53d8\u3002\u4f46\u662f\u7531\u4e8e\u53d7\u5230\u809d\u810f\u708e\u75c7\u3001\u80c6\u6c41\u6de4\u79ef\u3001\u64cd\u4f5c\u89c4\u8303\u7b49\u56e0\u7d20\u5f71\u54cd\uff0c\u5728\u8bca\u65adNASH\u7ea4\u7ef4\u5316\u7a0b\u5ea6\u548c\u5224\u65ad\u6cbb\u7597\u524d\u540e\u7597\u6548\u65b9\u9762\uff0c\u4ecd\u4e0d\u80fd\u66ff\u4ee3\u7ec4\u7ec7\u75c5\u7406\u5b66\u8bc4\u4ef7\u3002<\/span><\/p>\n

4\uff09\u8840\u6e05\u5b66\u8bc4\u4ef7<\/span><\/p>\n

\u65e0\u521b\u6307\u6807\u4e2d\uff0c\u4e0e\u8bc4\u4ef7\u7cd6\u8102\u4ee3\u8c22\u76f8\u5173\u7684\u6709\u4f53\u91cd\u3001\u4f53\u8d28\u91cf\u6307\u6570\uff08BMI\uff09\u3001\u8170\u81c0\u6bd4\u3001\u7a7a\u8179\u8840\u7cd6\u3001\u7cd6\u5316\u8840\u7ea2\u86cb\u767d\u3001\u80f0\u5c9b\u7d20\u62b5\u6297\uff08\u5982HOMA-IR\uff09\u3001\u8840\u8102\u7b49\u3002\u4e0e\u809d\u810f\u708e\u75c7\/\u635f\u4f24\u76f8\u5173\u7684\u6709ALT\u3001AST\u3001CK18\u7247\u6bb5\u7b49\u3002\u4e0e\u8bc4\u4ef7\u809d\u7ea4\u7ef4\u5316\u76f8\u5173\u7684\u6709FibroTest\u3001ELF\uff08EnhancedLiver Fibrosis\uff09\u3001NAFLD\u7ea4\u7ef4\u5316\u8bc4\u5206\uff08NAFLDFibrosis Score\uff0cNFS\uff09\u3001Pro-C3\u3001FIB-4\u3001AST\u4e0ePLT\u6bd4\u503c\u6307\u6570\uff08AST\/PLTRatio Index\uff0cAPRI\uff09\u3002<\/span><\/p>\n

5\uff09\u5176\u4ed6<\/span><\/p>\n

\u7528\u4e8e\u8bc4\u4ef7\u809d\u786c\u5316\u4e34\u5e8a\u7ed3\u5c40\u7684\u6307\u6807\u5305\u62ec\u809d\u9759\u8109\u538b\u529b\u68af\u5ea6\uff08HepaticVenous Pressure Gradient\uff0cHVPG\uff09\u548cChild-Pugh\u3001\u7ec8\u672b\u671f\u809d\u75c5\u6a21\u578b\uff08Modelfor End-stage Liver Disease\uff0cMELD\uff09\u8bc4\u5206\u7684\u53d8\u5316\u3002<\/span><\/p>\n

3.1.3\u65b9\u6cd5\u5b66\u8003\u8651<\/span><\/p>\n

\u65e2\u63a5\u53d7\u4f20\u7edf\u7684\u4e34\u5e8a\u7814\u53d1\u8bbe\u8ba1\uff0c\u4e5f\u63a5\u53d7\u65b0\u9896\u8bbe\u8ba1\uff0c\u5982\u9002\u5e94\u6027\/\u65e0\u7f1d\u8bbe\u8ba1\u7b49\uff0c\u4f46\u5e94\u5728\u65b9\u6848\u4e2d\u4e8b\u5148\u8bf4\u660e\u3002\u5982\u91c7\u7528\u65b0\u9896\u8bbe\u8ba1\uff0c\u5efa\u8bae\u4e0e\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u90e8\u95e8\u4e8b\u5148\u6c9f\u901a\u3002<\/span><\/p>\n

\u968f\u673a\u5206\u7ec4\u65f6\u5efa\u8bae\u91c7\u7528\u5206\u5c42\u968f\u673a\u5316\u7684\u65b9\u6cd5\uff0c\u5982\u8003\u8651\u7cd6\u5c3f\u75c5\u7b49\u5e76\u5b58\u75be\u75c5\u56e0\u7d20\u3002<\/span><\/p>\n

\u5728\u968f\u673a\u5206\u7ec4\u524d\u8bbe\u7f6e6\u5468\uff5e8\u5468\u5bfc\u5165\u671f\uff0c\u8fdb\u884c\u53d7\u8bd5\u8005\u6559\u80b2\u3001\u4f18\u5316\u996e\u98df\u548c\u8fd0\u52a8\u5b89\u6392\uff0c\u6539\u5584\u751f\u6d3b\u65b9\u5f0f\uff0c\u4ee5\u5e2e\u52a9\u8bc4\u4ef7\u53d7\u8bd5\u8005\u4f9d\u4ece\u6027\uff0c\u4ee5\u53ca\u786e\u4fdd\u4f53\u91cd\u548c\u4ee3\u8c22\u53c2\u6570\u7b49\u7684\u7a33\u5b9a\u3002\u7a33\u5b9a\u7684\u4f53\u91cd\u5b9a\u4e49\u4e3a\u53d8\u5316\u4e0d\u8d85\u8fc75%\u3002<\/span><\/p>\n

\u5982\u679c\u6709\u5408\u5e76\u7528\u836f\uff0c\u5e94\u8be5\u6709\u81f3\u5c116\u4e2a\u6708\u7684\u7a33\u5b9a\u5242\u91cf\u3002<\/span><\/p>\n

\u5982\u7814\u7a76\u4e2d\u6d89\u53ca\u591a\u4e2a\u836f\u7269\u591a\u9776\u70b9\u8054\u5408\u6cbb\u7597\u6216\u56fa\u5b9a\u5242\u91cf\u590d\u65b9\u5236\u5242\uff0c\u9700\u8981\u63d0\u4f9b\u8054\u5408\u7528\u836f\u7684\u5145\u5206\u4f9d\u636e\u3002<\/span><\/p>\n

\u5982\u7814\u7a76\u4e2d\u6d89\u53ca\u5408\u5e76\u7528\u836f\uff0c\u5305\u62ec\u4e2d\u836f\u7b49\uff0c\u9700\u8981\u5728\u7814\u7a76\u65b9\u6848\u4e2d\u660e\u786e\u89c4\u5b9a\uff0c\u5e76\u8be6\u7ec6\u8bb0\u5f55\u76f8\u5173\u4fe1\u606f\u3002<\/span><\/p>\n

\u5728\u56fd\u9645\u591a\u4e2d\u5fc3\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u56e0NASH\u4e0e\u996e\u98df\u7b49\u751f\u6d3b\u65b9\u5f0f\u53ca\u9057\u4f20\u4ee3\u8c22\u56e0\u7d20\u76f8\u5173\uff0c\u5e94\u5173\u6ce8\u79cd\u65cf\u5dee\u5f02\uff08\u5305\u62ec\u4e34\u5e8a\u836f\u7406\u5b66\u548c\u4e34\u5e8a\u5b9e\u8df5\u65b9\u9762\u7684\u5dee\u5f02\uff09\u3002\u5efa\u8bae\u5728\u65e9\u671f\u9636\u6bb5\u52a0\u5165\u5168\u7403\u7814\u53d1\uff0c\u4ee5\u5145\u5206\u4fdd\u8bc1\u53d7\u8bd5\u8005\u80fd\u591f\u4ee3\u8868\u4e2d\u56fd\u4eba\u7fa4\u3002<\/span><\/p>\n

3.2 \u4e0d\u540c\u7814\u53d1\u9636\u6bb5\u5177\u4f53\u8003\u8651<\/span><\/p>\n

3.2.1 \u4e34\u5e8a\u836f\u7406\u5b66\u7814\u7a76<\/span><\/p>\n

\u901a\u5e38\uff0c\u4e34\u5e8a\u836f\u7406\u5b66\u7814\u7a76\u5305\u62ec\u4eba\u4f53\u8010\u53d7\u6027\u8bd5\u9a8c\u3001\u4eba\u4f53\u836f\u4ee3\u52a8\u529b\u5b66\u548c\u836f\u52a8\u5b66\/\u836f\u6548\u5b66\u8bd5\u9a8c\u3002<\/span><\/p>\n

\u7531\u4e8e\u6cbb\u7597NASH\u7684\u836f\u7269\u591a\u9700\u8f83\u957f\u65f6\u671f\u7ed9\u836f\uff0c\u56e0\u6b64\uff0c\u9664\u975e\u53d7\u836f\u7269\u7684\u6bd2\u6027\u6216\u836f\u7406\u4f5c\u7528\u6240\u7981\u5fcc\uff0c\u5728\u591a\u6b21\u7ed9\u836f\u8010\u53d7\u6027\u8bd5\u9a8c\u4e2d\u7ed9\u836f\u7684\u65f6\u95f4\u5e94\u8db3\u591f\u957f\uff0c\u6700\u5c11\u5e94\u8fde\u7eed\u7ed9\u836f\u4e00\u5468\uff0c\u82e5\u836f\u7269\u53ca\u5176\u4ee3\u8c22\u7269\u8840\u6d53\u5ea6\u4e0d\u80fd\u8fbe\u7a33\u6001\uff0c\u5219\u5e94\u9002\u5f53\u5ef6\u957f\u3002<\/span><\/p>\n

\u5728\u672a\u83b7\u5f97\u809d\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u7684\u836f\u4ee3\u6570\u636e\u4e4b\u524d\uff0c\u5e94\u6392\u9664\u8be5\u90e8\u5206\u4eba\u7fa4\u3002<\/span><\/p>\n

\u5728\u836f\u7269\u7684\u65e9\u671f\u7814\u53d1\u9636\u6bb5\uff0c\u53ef\u4ee5\u8003\u8651\u4ee5\u5f71\u50cf\u5b66\u3001\u8840\u6e05\u5b66\u3001NASH\u809d\u7ea4\u7ef4\u5316\u65e0\u521b\u5224\u522b\u6a21\u578b\u4f5c\u4e3a\u836f\u6548\u5b66\u6307\u6807\uff0c\u8fdb\u884c\u5c0f\u6837\u672c\u3001\u77ed\u7597\u7a0b\u7684\u836f\u52a8\u5b66\/\u836f\u6548\u5b66\u8bc4\u4f30\uff0c\u5168\u9762\u4e86\u89e3\u836f\u7269\u7684\u66b4\u9732\/\u6548\u5e94\u4f5c\u7528\u7279\u70b9\uff0c\u4e3a\u540e\u7eed\u4e34\u5e8a\u8bd5\u9a8c\u63d0\u4f9b\u6307\u5bfc\u3002<\/span><\/p>\n

NASH\u60a3\u8005\u5e38\u540c\u65f6\u5408\u5e76\u7cd6\u5c3f\u75c5\u3001\u9ad8\u8840\u538b\u3001\u9ad8\u8102\u8840\u75c7\u3001\u75db\u98ce\u7b49\u4ee3\u8c22\u76f8\u5173\u75be\u75c5\uff0c\u800c\u4e14\uff0c\u6b64\u7c7b\u60a3\u8005\u7684\u5fc3\u8111\u8840\u7ba1\u4e8b\u4ef6\u98ce\u9669\u589e\u52a0\u3002\u5728NASH\u836f\u7269\u65e9\u671f\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u5e94\u81f3\u5c11\u5f00\u5c55\u4e0e\u5e38\u7528\u6297\u7cd6\u5c3f\u75c5\u836f\u3001\u6297\u9ad8\u8840\u538b\u836f\u3001\u8c03\u8102\u836f\u7b49\u7684\u836f\u7269\u76f8\u4e92\u4f5c\u7528\u7814\u7a76\u3002<\/span><\/p>\n

3.2.2 \u63a2\u7d22\u6027\u4e34\u5e8a\u8bd5\u9a8c<\/span><\/p>\n

1\uff09\u65e9\u671f\u6982\u5ff5\u9a8c\u8bc1<\/span><\/p>\n

NASH\u836f\u7269\u7684\u65e9\u671f\u6982\u5ff5\u9a8c\u8bc1\u5e94\u7b26\u5408\u8be5\u671f\u7684\u4e00\u822c\u539f\u5219\u3002\u63d0\u4f9b\u521d\u6b65\u7684\u8bc1\u636e\u652f\u6301\u540e\u7eed\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff0c\u5305\u62ec\u5165\u7ec4\u6807\u51c6\u3001\u4e34\u5e8a\u8bd5\u9a8c\u7684\u5468\u671f\u4ee5\u53ca\u7ec8\u70b9\u7684\u8bbe\u7f6e\u3002<\/span><\/p>\n

\u53d7\u8bd5\u8005\u7684\u5165\u9009\u53ef\u91c7\u7528\u8840\u6e05\u751f\u5316\u68c0\u67e5\u6216\u5f71\u50cf\u5b66\u65b9\u6cd5\u3002<\/span><\/p>\n

\u4e3b\u8981\u7597\u6548\u6307\u6807\u53ef\u91c7\u7528\u65e0\u521b\u6027\u6807\u5fd7\u7269\uff0c\u5305\u62ecMRI-PDFF\u3001MRE\u7b49\u5f71\u50cf\u5b66\u6539\u53d8\uff0c\u4ee5\u53ca\u809d\u810f\u75be\u75c5\u7279\u5f02\u6027\u7684\u8840\u6e05\u751f\u5316\u6307\u6807\u7684\u53d8\u5316\u7b49\uff0c\u4e5f\u53ef\u7ed3\u5408\u7ec4\u7ec7\u75c5\u7406\u5b66\u3001\u5f71\u50cf\u5b66\u548c\u8840\u6e05\u751f\u5316\u68c0\u67e5\u7b49\u65e0\u521b\u6807\u5fd7\u7269\u7684\u53d8\u5316\u5171\u540c\u8bc4\u4ef7\u809d\u810f\u8102\u80aa\u542b\u91cf\u548c\u708e\u75c7\/\u7ea4\u7ef4\u5316\u3002<\/span><\/p>\n

\u7ed9\u836f\u5242\u91cf\u548c\u6cbb\u7597\u6301\u7eed\u65f6\u95f4\u8981\u6839\u636e\u4f5c\u7528\u673a\u5236\u53ca\u5bf9\u4e8e\u6240\u9009\u7597\u6548\u6307\u6807\u7684\u9884\u671f\u4f5c\u7528\u6765\u8bbe\u8ba1\uff0c\u5e94\u6709\u8db3\u591f\u957f\u7684\u7ec8\u70b9\u89c2\u5bdf\u65f6\u95f4\u3002\u5efa\u8bae\u8be5\u9636\u6bb5\u5305\u62ec\u591a\u4e2a\u5242\u91cf\u63a2\u7d22\u4f5c\u4e3a\u540e\u7eed\u8bbe\u8ba1\u7684\u9009\u62e9\u3002<\/span><\/p>\n

2\uff09\u540e\u671f\u63a2\u7d22<\/span><\/p>\n

\u5efa\u8bae\u91c7\u7528\u5b89\u6170\u5242\u5bf9\u7167\u3001\u968f\u673a\u3001\u53cc\u76f2\u8bbe\u8ba1\u3002<\/span><\/p>\n

\u53d7\u8bd5\u8005\uff1a\u5165\u9009\u9700\u8003\u8651\u5e74\u9f84\u3001\u6027\u522b\u3001\u8bca\u65ad\u6807\u51c6\u3001\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u3001\u5408\u5e76\u75be\u75c5\u7b49\u3002\u5efa\u8bae\u7eb3\u5165\u7ecf\u809d\u7ec4\u7ec7\u75c5\u7406\u5b66\u786e\u8bca\u7684NASH\u60a3\u8005\uff0c\u809d\u7ec4\u7ec7\u6d3b\u68c0\u81f3\u5165\u7ec4\u7684\u65f6\u95f4\u7a97\u4e00\u822c\u4e0d\u8d85\u8fc76\u4e2a\u6708\uff0c\u5728\u8be5\u65f6\u95f4\u7a97\u5185\u9700\u6ce8\u610f\u60a3\u8005\u662f\u5426\u63a5\u53d7\u53ef\u80fd\u5f71\u54cd\u809d\u7ec4\u7ec7\u5b66\u53d8\u5316\u7684\u5e72\u9884\u3002\u5165\u7ec4\u6807\u51c6\uff1aNAS\u8bc4\u5206\u22654\u5206\uff0c\u5176\u4e2d\u708e\u75c7\u548c\u6c14\u7403\u6837\u53d8\u5404\u81f3\u5c111\u5206\uff1b\u540c\u65f6\uff0cCRN\u7ea4\u7ef4\u5316\u2265F2\u3002\u6392\u9664\u6807\u51c6\uff1aALT\u548cAST\u5347\u9ad8\u8d85\u8fc7\u6b63\u5e38\u4e0a\u9650\uff08ULN\uff09\u76845\u500d\uff0c\u80c6\u7ea2\u7d20\u6c34\u5e73\u4e0d\u5e94\u8d85\u8fc7ULN\uff0cMELD\u8bc4\u5206\uff1e12\u5206\uff0cCTP\u8bc4\u5206\uff1e5\u5206\u3002<\/span><\/p>\n

\u4e3b\u8981\u7597\u6548\u6307\u6807\uff1a\u5e94\u4ee5\u7ec4\u7ec7\u5b66\u6539\u5584\u4e3a\u4e3b\u8981\u7597\u6548\u6307\u6807\u3002\u5305\u62ec\uff1a\u2460NASH\u6539\u5584\u540c\u65f6\uff0c\u7ea4\u7ef4\u5316\u65e0\u6076\u5316\uff1b\u6216\u8005\uff0c\u2461\u809d\u7ec4\u7ec7\u7ea4\u7ef4\u5316\u6539\u55841\u5206\u53ca\u4ee5\u4e0a\uff0c\u540c\u65f6\uff0cNAS\u8bc4\u5206\u65e0\u5347\u9ad8\uff1b\u6216\u8005\uff0c\u2462NASH\u6539\u5584\u540c\u65f6\u809d\u7ec4\u7ec7\u7ea4\u7ef4\u5316\u6539\u55841\u5206\u53ca\u4ee5\u4e0a\u3002NASH\u6539\u5584\u5b9a\u4e49\u4e3aNAS\u8bc4\u5206\u81f3\u5c11\u964d\u4f4e2\u5206\uff0c\u5176\u4e2d\u708e\u75c7\u548c\u6c14\u7403\u6837\u53d8\u5404\u81f3\u5c11\u964d\u4f4e1\u5206\u3002<\/span><\/p>\n

\u7ed9\u836f\u5242\u91cf\u548c\u6cbb\u7597\u6301\u7eed\u65f6\u95f4\uff1a\u53ef\u8bbe\u7f6e\u591a\u4e2a\u5242\u91cf\u7ec4\uff0c\u8bc4\u4ef7\u836f\u7269\u7684\u91cf\u6548\u5173\u7cfb\u3002\u5e94\u4fdd\u8bc1\u8db3\u591f\u957f\u7684\u7814\u7a76\u65f6\u95f4\u4ee5\u89c2\u5bdf\u7ec4\u7ec7\u5b66\u6539\u5584\uff0c\u81f3\u5c11\u8981\u8fbe\u523012\uff5e18\u6708\u3002<\/span><\/p>\n

3.2.3 \u786e\u8bc1\u6027\u4e34\u5e8a\u8bd5\u9a8c<\/span><\/p>\n

\u8bbe\u8ba1\uff1a\u968f\u673a\u3001\u53cc\u76f2\u3001\u5b89\u6170\u5242\u5e73\u884c\u5bf9\u7167\u3002<\/span><\/p>\n

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\u7531\u4e8eNASH\u7684\u6cbb\u7597\u53ef\u80fd\u9700\u8981\u957f\u671f\u670d\u836f\uff0c\u5e94\u5305\u62ec\u505c\u836f\u540e\u968f\u8bbf\u3002<\/span><\/p>\n

\u5728\u786e\u8bc1\u6027\u4e34\u5e8a\u8bd5\u9a8c\u540c\u65f6\u53ef\u8fdb\u884c\u7fa4\u4f53\u836f\u4ee3\u52a8\u529b\u5b66\u7814\u7a76\u3001\u836f\u7269\u57fa\u56e0\u7ec4\u5b66\u7814\u7a76\u7b49\u3002<\/span><\/p>\n

3.2.4 \u786e\u8bc1\u4e34\u5e8a\u83b7\u76ca\u7684\u8bd5\u9a8c<\/span><\/p>\n

\u9274\u4e8e\u7ec4\u7ec7\u5b66\u6539\u5584\u7684\u66ff\u4ee3\u7ec8\u70b9\u4e0e\u4e34\u5e8a\u7ed3\u5c40\u7684\u76f8\u5173\u6027\u5c1a\u672a\u786e\u7acb\uff0c\u5e94\u8fdb\u884c\u4e34\u5e8a\u8bd5\u9a8c\u786e\u8bc1\u4e34\u5e8a\u7ed3\u5c40\u7684\u83b7\u76ca\uff0c\u53ef\u4ee5\u63a5\u53d7\u5728\u4e0a\u5e02\u540e\u5f00\u5c55\u8be5\u8bd5\u9a8c\u3002<\/span><\/p>\n

3.3 \u5b89\u5168\u6027\u8bc4\u4ef7<\/span><\/p>\n

\u7531\u4e8eNASH\u9700\u8981\u957f\u65f6\u95f4\u7684\u8fde\u7eed\u670d\u836f\uff0c\u56e0\u6b64\u9700\u8981\u6709\u8db3\u591f\u7684\u66b4\u9732\u91cf\u548c\u66b4\u9732\u65f6\u95f4\u8fdb\u884c\u5b89\u5168\u6027\u89c2\u5bdf\u3002\u5efa\u8bae\u5728\u957f\u671f\u8bd5\u9a8c\u4e2d\u8bbe\u7acb\u72ec\u7acb\u7684\u79d1\u5b66\u59d4\u5458\u4f1a\u3002<\/span><\/p>\n

NASH\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u5e94\u7279\u522b\u5173\u6ce8\u4ee5\u4e0b\u53ef\u80fd\u7684\u4e0d\u826f\u4e8b\u4ef6\uff1a<\/span><\/p>\n

\u2460\u809d\u810f\u4e0d\u826f\u4e8b\u4ef6\uff1a\u7531\u4e8eNASH\u60a3\u8005\u5bf9\u836f\u7269\u6240\u81f4\u7684\u809d\u635f\u654f\u611f\u6027\u589e\u52a0\uff0c\u6709\u65f6\u836f\u7269\u53ef\u80fd\u8bf1\u53d1\u809d\u635f\u4f24\u52a0\u91cd\uff0c\u8bbe\u8ba1\u4e34\u5e8a\u8bd5\u9a8c\u65f6\u5e94\u5c06\u8fd9\u4e00\u53ef\u80fd\u6027\u8003\u8651\u5728\u5185\u3002\u5e94\u5c3d\u91cf\u786e\u5b9a\u809d\u635f\u4f24\u52a0\u91cd\u7684\u539f\u56e0\uff0c\u8fd8\u5e94\u7279\u522b\u5173\u6ce8\u505c\u836f\u540e\u53cd\u8df3\u6027\u809d\u529f\u80fd\u5f02\u5e38\u3002\u5bf9\u4e8e\u6709\u6f5c\u5728\u809d\u810f\u6bd2\u6027\u7684\u836f\u7269\uff0c\u5e94\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u8bbe\u7acb\u76d1\u6d4b\u8ba1\u5212\u3002<\/span><\/p>\n

\u2461\u80be\u810f\u4e0d\u826f\u4e8b\u4ef6\uff1a\u7531\u4e8eNASH\u672c\u8eab\u4f1a\u589e\u52a0\u6162\u6027\u80be\u810f\u75be\u75c5\u7684\u98ce\u9669\uff0c\u5728\u8bd5\u9a8c\u524d\u548c\u8bd5\u9a8c\u8fc7\u7a0b\u4e2d\u8981\u5168\u9762\u8bc4\u4f30\u548c\u76d1\u6d4b\u53d7\u8bd5\u8005\u7684\u80be\u810f\u529f\u80fd\u3002<\/span><\/p>\n

\u2462\u5fc3\u8840\u7ba1\u4e0d\u826f\u4e8b\u4ef6\uff1a\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u662fNASH\u60a3\u8005\u7684\u4e3b\u8981\u6b7b\u56e0\uff0c\u5e94\u6839\u636e\u836f\u7269\u7684\u7279\u70b9\uff0c\u76d1\u6d4b\u836f\u7269\u5bf9\u5fc3\u8840\u7ba1\u7cfb\u7edf\u7684\u5f71\u54cd\u3002<\/span><\/p>\n

\u2463\u4ee3\u8c22\u548c\u5185\u5206\u6ccc\u4e0d\u826f\u4e8b\u4ef6\uff1aNASH\u5e38\u5408\u5e76\u4ee3\u8c22\u7efc\u5408\u5f81\uff0c\u5e94\u6839\u636e\u836f\u7269\u7684\u7279\u70b9\uff0c\u76d1\u6d4b\u5bf9\u4f53\u91cd\u3001\u8840\u7cd6\u548c\u80f0\u5c9b\u7d20\u7b49\u4ee3\u8c22\u6307\u6807\u7684\u5f71\u54cd\u3002<\/span><\/p>\n

\u3010\u53c2\u8003\u6587\u732e\u3011<\/span><\/p>\n

1. \u4e2d\u56fd\u975e\u9152\u7cbe\u6027\u8102\u80aa\u6027\u809d\u75c5\u8bca\u7597\u9632\u6cbb\u6307\u5357\uff082018\u5e74\u4fee\u8ba2\u66f4\u65b0\u7248\uff09<\/span><\/p>\n

2.Younossi Z M\uff0cKoenigA B\uff0cAbdelatifD\uff0cetal. Global epidemiology of nonalcoholic fatty liver disease\u2014meta-analyticassessment of prevalence\uff0cincidence\uff0candoutcome[J].Hepatology\uff0c2016\uff0c64\uff081\uff09\uff1a73-84.<\/span><\/p>\n

\u6765\u6e90\uff1a<\/strong>\u56fd\u5bb6\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40\u836f\u54c1\u5ba1\u8bc4\u4e2d\u5fc3<\/span><\/strong><\/p>\n

\"CDE\u516c\u5f00\u5f81\u6c42\"CDE\u516c\u5f00\u5f81\u6c42<\/span><\/p>\n<\/section>\n<\/section><\/div>\n","protected":false},"excerpt":{"rendered":"

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