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1.
尚画雨  夏志 《卫生研究》2021,(4):691-697
非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)包括肝脂肪变性、非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)、肝纤维化和肝硬化等进程,目前已成为与现代生活方式(能量过度摄入和缺乏运动)相关的重大健康问题.虽然从肝脂肪变性发展为NA...  相似文献   

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目的研究超声肝纤维化检测在非酒精性脂肪肝诊断中的应用价值。方法 2016年4月—2017年3月收集非酒精性脂肪肝病患者238例,根据临床分期分为非酒精性单纯性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)、非酒精性脂肪性肝硬化(NAS)3个亚组,均进行彩色多普勒超声量化评分、瞬时弹性Fibrotouch无创肝脏硬度检测、血清肝纤维化指标检测,比较分析不同临床分期肝脏硬度及超声量化评分之间的关系。结果不同分期亚组间肝脏硬度平均LS值两两比较差异均具有统计意义(P值均为0.000,P0.05),3组间差异也具有统计学意义(χ~2=28.342,P=0.000)。Pearman相关分析结果表明NAFLD各分期亚组肝脏硬度LS值与UQS均呈强相关,NAS亚组值与肝纤维化生化指标呈强相关(r0.5)。结论非酒精性脂肪肝病应用肝脏硬度检测与彩色多普勒超声及血清纤维化指标相关性良好,有望早期诊疗肝纤维化防止肝硬化发展。  相似文献   

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1 非酒精性脂肪性肝病(NAFLD) 1.1 定义 NAFLD[1]是一种病变主体在肝小叶,以肝细胞脂肪变性和脂肪堆积为病理特征但无过量饮酒史的临床综合征.在西方许多国家,它被认为是肝功能实验室检查异常的首要因素之一.NAFLD包括:单纯性脂肪肝和非酒精性脂肪性肝炎(NASH).NASH是由Ludwig等人首先提出来的[2].与酒精性肝炎相比,NASH的损害程度虽然要弱一些,但它也会发生炎性坏死,早期出现肝纤维化和肝硬化,存在进行性肝损害.其中大约50%的病人会出现肝纤维化,15%的人会出现肝硬化,3%的人最终发展为肝衰竭而需要肝移植[1].而单纯性脂肪肝不伴有坏死性炎症的发生,因而是一种良性且无进行性肝损害的疾病.  相似文献   

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1 非酒精性脂肪性肝病 (NAFLD)1.1 定义 NAFLD[1] 是一种病变主体在肝小叶 ,以肝细胞脂肪变性和脂肪堆积为病理特征但无过量饮酒史的临床综合征。在西方许多国家 ,它被认为是肝功能实验室检查异常的首要因素之一。NAFLD包括 :单纯性脂肪肝和非酒精性脂肪性肝炎 (NASH)。NASH是由Ludwig等人首先提出来的[2 ] 。与酒精性肝炎相比 ,NASH的损害程度虽然要弱一些 ,但它也会发生炎性坏死 ,早期出现肝纤维化和肝硬化 ,存在进行性肝损害。其中大约 5 0 %的病人会出现肝纤维化 ,15 %的人会出现肝硬化 ,3%的人最终发展为肝衰竭而需要肝…  相似文献   

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非酒精性脂肪肝病(nonalcoholic fatty lier disease,NAFLD)指病变主体在肝小叶,以肝细胞脂肪变性和脂肪沉积为病理特征,但无过量饮酒史的临床综合征,包括从单纯性脂肪肝到非酒精性脂肪肝炎(nonalcoliholicsteatohepatitis,NASH)、肝纤维化,最后至肝硬化三种类型.  相似文献   

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<正>非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)是代谢综合征在肝脏的表现形式,涵盖了从简单肝脂肪细胞变性即脂肪肝(nonalcoholic fatty liver,NAFL)、非酒精性脂肪肝炎(nonalcoholic steatohepatitis,NASH)到肝硬化、肝细胞癌(hepatocellular carcinoma,HCC)在内的肝脏代谢综合征的系列症  相似文献   

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<正>非酒精性脂肪肝病(Nonalcoholic fatty liver disease,NAFLD),是指通过影像或组织学证据表明存在肝脂肪变性,以及排除大量饮酒、使用致脂肪变性药物或遗传性疾病引起的二次肝脂肪堆积。包括相对良性的简单脂肪变性进展为非酒精性脂肪肝炎(nonalcoholic steatohepatitis,NASH)、肝纤维化和肝硬化。NAFLD包括一系列的无症状肝脏疾病,可能会  相似文献   

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非酒精性脂肪性肝病(NAFLD)在临床中是一种与遗传易感以及胰岛素抵抗(IR)密切联系的代谢应激性肝损伤.它的疾病谱包括非酒精性脂肪性肝炎(NASH)、非酒精性单纯性肝脂肪变、肝硬化以及肝细胞癌(HCC).NAFLD不仅会导致患者出现肝脏功能障碍的问题,甚至很可能威胁到NAFLD患者的生命.除此之外,NAFLD还和2型...  相似文献   

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非酒精性脂肪性肝病发病机制进展   总被引:4,自引:2,他引:2  
非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)是一种遗传-环境-代谢应激相关性疾病,代谢紊乱、氧化应激及细胞因子等多种因素共同作用导致肝脏的脂质合成与排泄失衡,肝细胞内脂肪蓄积,进而发展为非酒精性脂肪性肝炎(nonalcoholic steatohepatitis,NASH)和肝硬化.  相似文献   

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脂肪肝即脂肪性肝病,是一种多病因引起的疾病,病变主体在肝小叶以肝细胞脂肪变性和脂肪沉积为主的病理综合征,主要包括单纯性脂肪肝、脂肪性肝炎(NASH)和脂肪性肝硬化3种类型,病因分酒精性和非酒精性。  相似文献   

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In the past two decades, research on the sociology of diagnosis has attained considerable influence within medical sociology. Analyzing the process and factors that contribute to making a diagnosis amidst uncertainty and contestation, as well as the diagnostic encounter itself, are topics rich for sociological investigation. This paper provides a reformulation of the sociology of diagnosis by proposing the concept of 'social diagnosis' which helps us recognize the interplay between larger social structures and individual or community illness manifestations. By outlining a conceptual frame, exploring how social scientists, medical professionals and laypeople contribute to social diagnosis, and providing a case study of how the North American Mohawk Akwesasne reservation dealt with rising obesity prevalence to further illustrate the social diagnosis idea, we embark on developing a cohesive and updated framework for a sociology of diagnosis. This approach is useful not just for sociological research, but has direct implications for the fields of medicine and public health. Approaching diagnosis from this integrated perspective potentially provides a broader context for practitioners and researchers to understand extra-medical factors, which in turn has consequences for patient care and health outcomes.  相似文献   

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胆囊炎症性疾病比较常见 ,随着新设备新技术的不断出现 ,其影像诊断水平发展较快。在选择内科、外科或介入性疗法前多需采用合理有效的影像学检查以保证诊断的准确性。1 各种影像学检查方法的现状X线平片与体层摄影以及静脉法胆系造影虽已失去当年检查此类疾病的主导作用 ,但在某些情况下仍可用作参考。口服法胆囊造影因显影效果欠佳已很少采用。超声 (US)、CT、MRI、磁共振胆胰管成像 (MR CP)、ERCP/PTC是目前常用的影像学检查方法 ,但仍都有其局限性 ,如 :US易受肠道气体影的干扰 ,普通CT横断面检查往往限制胆胰管树全貌的显示…  相似文献   

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Your diagnosis     
《Concours médical》1954,76(51):4755-4757
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目的探讨宫角妊娠的超声诊断及鉴别诊断要点。方法回顾性分析浙江省温岭市中医院2005年10月至2013年4月的56例门诊拟诊为宫角妊娠的病历资料。结果其中10例妊娠44天内的早期宫角妊娠2周内转为宫内妊娠;其余46例均经手术治疗和病理检查,其中38例为宫角妊娠(右侧20例,左侧18例),6例为间质部妊娠,1例为滋养细胞性疾病,1例为纵膈子宫一侧妊娠。宫角妊娠总的诊断准确率为67.86%,其中经腹部和经阴道超声诊断准确率分别为44.44%和63.16%,两种方法联合诊断准确率94.74%,联合组诊断准确率明显高于经腹部及阴超组(χ2值分别为11.19和5.70,P值分别为0.001和0.017)。结论①对于停经天数较短的早期诊断的宫角妊娠应密切观察,部分可以转为宫内妊娠;②超声是诊断宫角妊娠的有效方法,阴超与腹部超声两种检查方法联合应用能够大大提高诊断的准确率。  相似文献   

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Making an accurate diagnosis is essential to ensure that a patient receives appropriate treatment and correct information regarding their prognosis. Characteristics of diagnostic tests are quantified in test accuracy studies, but many such studies have methodological flaws. The HSRC evidence-based diagnosis programme has focused on methods for systematic reviews of test accuracy studies, and the wider context in which tests are ordered and interpreted. We carried out a range of projects relating to literature searching, quality assessment, meta-analysis, presentation of results, and interactions between doctors and patients during the diagnostic process. We have shown that systematic reviews of test accuracy studies should search a range of databases and that current diagnostic filters do not have sufficient accuracy to be used in test accuracy reviews. Summary quality scores should not be used in test accuracy reviews; the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Reviews (QUADAS) tool for assessing test accuracy studies is acceptable for quality assessment. We have shown that the hierarchical summary receiver operating characteristic (HSROC) and bivariate models for meta-analysis of test accuracy are statistically equivalent in many circumstances, and have developed an add-on module for the statistical software package Stata that enables these statistically rigorous models to be fitted by those without expert statistical knowledge. Three areas that would benefit from further research are literature searching, synthesis of results from individual patient data and presentation of results.  相似文献   

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Effective communications are essential for any operation and for management of health-related problems. Telemedicine has altered profoundly the manner in which primary care physicians can interact with hospitals and specialists. As dedicated medical ICT systems evolve, medical care will be delivered to patients in remote locations in a more efficient and cost-effective way. Companies invariably have a vision that healthcare decisions benefiting patient care should be made anytime and anywhere in a model that facilitates care at the point of need. The development of telemedicine programs is inevitable as business globalization expands to more challenging cultural and geographic areas.  相似文献   

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