Аннотация
На данный момент диагностика патологии печени очень сложна и многогранна. К сожалению, при своей значительной распространенности заболевания печени часто диагностируются на поздней стадии. Это происходит за счет бессимптомного течения, из-за чего заболевания дебютируют уже на стадии цирроза печени и его осложнений. Чаще всего на ранней стадии изменения лабораторных показателей могут выявляться как находка при обследовании и лечении по поводу других заболеваний. Одним из наиболее распространенных заболеваний печени является неалкогольная жировая болезнь печени (НАЖБП), которая несправедливо недооценена некоторыми практикующими врачами. НАЖБП включает в себя широкий спектр заболеваний различной степени тяжести с разными прогнозами: стеатоз, неалкогольный стеатогепатит, фиброз, цирроз и гепатоцеллюлярную карциному. Современный уровень науки и медицины требует постоянного пересмотра диагностики с внедрением новых методов и технологий, выставляя на первый план профилактику и установку диагноза на ранней стадии, до развития цирроза печени. Долгое время золотым стандартом диагностики являлась биопсия печени. Но инвазивная диагностика, такая как биопсия печени, не удовлетворяет требованиям безопасности, часто отвергается пациентами по причине болезненности и страха перед осложнениями, а также необходимостью госпитализации в стационар. На сегодняшний день наиболее актуальной является неинвазивная диагностика заболеваний печени. В данном обзоре представлены методы лабораторной диагностики, включая циркулирующие миРНК (малые интерферирующие РНК), генетическое исследование и биопсию печени, для возможности установления диагноза НАЖБП, их специфичность, распространенность и актуальность применения в клинической практике.
Annotation
Currently, the diagnosis of liver pathology is very complex and multifaceted. Unfortunately, despite their high prevalence, liver diseases are often diagnosed at a late stage. This is due to the asymptomatic course of the disease, which causes it to debut already at the stage of cirrhosis and its complications. Most often, at an early stage, changes in laboratory values can be detected as a finding during examination and treatment for other diseases. One of the most common liver diseases is Non-Alcoholic Fatty Liver Disease (NAFLD), which is unfairly underestimated by some practitioners. NAFLD includes a wide range of diseases of varying severity with different prognoses: steatosis, nonalcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. The modern level of science and medicine requires constant revision of diagnostics with the introduction of new methods and technologies, bringing to the forefront the prevention and diagnosis at an early stage, before the development of liver cirrhosis. For a long time, liver biopsy has been the gold standard for diagnosis. But invasive diagnostics, such as liver biopsy, do not meet safety requirements and are often rejected by patients because of pain and fear of complications, as well as the need for hospitalization. Today, noninvasive diagnosis of liver disease is the most relevant. This review presents methods of laboratory diagnosis, including circulating miRNA (small interfering RNA), genetic study and liver biopsy, for the possibility of establishing the diagnosis of NAFLD, their specificity, prevalence and relevance of application in clinical practice.
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