BMJ Best Practice
最后审核时间: 六月 2019
最近更新时间: 三月 2019

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 腹痛
  • 肝肿大
  • 呕血和黑便

其他诊断因素

  • 腹水
  • 体重减轻
  • 体重升高
  • 营养不良与消瘦

危险因素

  • 长期大量饮酒
  • 丙型肝炎
  • 女性
  • 吸烟

诊断性检查

首要检查

  • 血清 AST、ALT
  • 血清 AST/ALT 比值
  • 血清碱性磷酸酶
  • 血清胆红素
全部具体信息

需要考虑的检查

  • 病毒性肝炎血清学分析
  • 血清铁、铁蛋白、转铁蛋白
  • 尿铜(收集 24 小时)
  • 血清铜蓝蛋白
全部具体信息

新兴检查

  • 血清缺糖基转铁蛋白检测
  • 血清线粒体 AST
全部具体信息

治疗流程

疾病持续状态

贡献者

Craig McClain MD

Professor

Chief of Research Affairs

Associate Vice President for Health Affairs/Research

Division of Gastroenterology, Hepatology and Nutrition

Department of Medicine

University of Louisville School of Medicine

Louisville

KY

利益冲突披露
CM declares that he has no competing interests.
Luis Marsano MD

Professor and Director of Hepatology

Division of Gastroenterology, Hepatology and Nutrition

Department of Medicine

University of Louisville School of Medicine

Louisville

KY

利益冲突披露
LM is on the speaker bureau for Salix (maker of Rifaximin - Xifaxan); Rifaximin is part of the therapy (supported by practice guidelines) of hepatic encephalopathy. He is also on the speaker bureau of Grifols (one of the makers of albumin for IV infusion); albumin is used as part of the treatment of spontaneous bacterial peritonitis (supported by practice guidelines).

Dr Craig McClain and Dr Luis Marsano would like to gratefully acknowledge Dr Mihir Patel, a previous contributor to this monograph. MP declares that he has no competing interests.

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Postdoctoral Research Associate

Center for Alcohol and Addiction Studies

Brown University

Providence

RI

利益冲突披露
LL declares that he has no competing interests.

Assistant Professor of Medicine

University of Chicago

Center for Liver Disease

Chicago

IL

利益冲突披露
NR declares that she has no competing interests.

Head of Clinical Hepatology and Senior Lecturer

Division of Infection, Inflammation and Immunity

University of Southampton Medical School

Southampton General Hospital NHS Trust

Southampton

UK

利益冲突披露
NS has received research grants from the Medical Research Council (MRC), Wellcome Trust, British Liver Trust, Alcohol Education Research Council, and various other funding bodies. He has undertaken paid consultancy work and received travelling expenses from pharmaceutical companies developing drugs for the treatment of inflammatory bowel disease and liver disease. He has been paid for medico-legal work in the areas of hepatitis C and alcohol-related liver disease. The following memberships and advisory work are unpaid apart from travelling expenses: EU Alcohol Forum, EU Alcohol Marketing Taskforce, Royal College of Physicians Alcohol Committee, Alcohol Health Alliance UK. NS has undertaken advisory and media work for the UK Department of Health, Home Office, Department of Transport, Cross Cabinet Strategy Committee, NICE, Southampton City Council, UK Police, British Liver Trust, various other NGOs, local government, and other bodies. NS is an unpaid trustee of the Drinkaware Trust, an independent body set up by the UK Government to use industry resources to reduce alcohol-related harm. The Trust is funded entirely by the alcohol industry, with a board of trustees comprising 5 industry members, 5 members with alcohol-related health expertise, and 3 lay members.

Consultant Hepatologist

Royal Infirmary of Edinburgh

Edinburgh

UK

利益冲突披露
AM declares that he has no competing interests.

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