代谢 Dysfunction-Associated 脂肪变性 肝 疾病

迹象 & 症状

MASLD的发展通常需要几年的时间, 甚至几十年, with each stage of fibrosis (scarring) lasting an average of seven years. 该病可经历以下几个阶段:

• 0-1期(肝脏健康). 没有发生明显的肝损伤.
• 第二阶段(脂肪肝). 脂肪沉积导致肝脏增大.
• 3期(肝纤维化). 疤痕组织形态.
• 第四阶段(肝硬化). 新的结缔组织生长，破坏健康的肝细胞.

根据病程的不同，MASLD的体征和症状差别很大. During early and middle stages, patients often have no 症状 of liver disease.

然而, as the disease advances, liver scarring may cause 症状 that include:

• 乏力
• 记忆丧失或混乱
• 腹部或腿部积液
• 带柏油的黑色大便，表明内出血

诊断

MASLD is often found incidentally, as part of testing for an unrelated problem. To confirm the diagnosis, your provider may order the following tests:

• 血液测试. Certain tests can measure liver function and detect inflammatory activity; other blood tests may be used to rule out 病毒性肝炎(由某些病毒引起的肝脏炎症).
• 肝脏超声. 这个简单的 成像过程 can show irregularities in the liver's shape and consistency as well as problems involving the biliary tract, 比如胆结石.
• 计算机断层扫描(CT). 在这种成像方法中, an X-ray beam rotates around the patient and a computer creates a detailed view of structures within the body, 比如肝脏.
• 肝活组织检查. In some cases, providers need this to make a definitive diagnosis. The biopsy results also help define the stage of MASLD and severity of liver inflammation. To obtain a small tissue sample for analysis, a needle is inserted into the liver. The procedure is performed in the clinic under local anesthesia (medications that prevent pain in a specific area).

治疗

For patients with 肥胖 and high levels of damaging bloodstream lipids (fat), 减肥是MASLD的推荐治疗方法. If patients are able to lose weight and maintain the weight loss, MASLD and MASH can be reversed.

对于糖尿病患者高血压或高胆固醇, controlling blood sugar levels can help prevent additional liver injury. 所有MASLD患者应避免饮酒, highly processed foods and foods with high levels of added sugar.

MASLD的治疗选择正在迅速发展. 加州大学旧金山分校十大赌博靠谱网络平台了许多 临床试验 and other studies investigating promising new medications for MASLD, 以及其他创新的治疗方法.

肝移植

在某些情况下，MASLD可能发展为肝功能衰竭并需要 肝移植. The evaluation for a transplant is complex and generally requires several months. 因此, even patients who feel well should be referred for a transplant at the first sign of liver failure or if they have advanced liver disease diagnosed by X-ray studies or liver biopsy.