每3-6个月或出现症状时均应做肝功能检查(包括AST,ALT,总胆红素,碱性磷酸酶)。也应定期检测血小板计数,凝血酶原时间,以及白蛋白的变化,以及肝硬化的进展情况。
所有患者一旦诊断,应每隔2-3年,完善骨密度检查以排除肝性骨营养不良。[37]Zein CO, Jorgensen RA, Clarke B, et al. Alendronate improves bone mineral density in primary biliary cirrhosis: a randomized placebo-controlled trial. Hepatology. 2005;42:762-771.http://onlinelibrary.wiley.com/doi/10.1002/hep.20866/fullhttp://www.ncbi.nlm.nih.gov/pubmed/16175618?tool=bestpractice.com[38]Collier J. Bone disorders in chronic liver disease. Hepatology. 2007;46:1271-1278.http://onlinelibrary.wiley.com/doi/10.1002/hep.21852/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17886334?tool=bestpractice.com[25]Chapman R, Fevery J, Kalloo A, et al. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51:660-678.http://onlinelibrary.wiley.com/doi/10.1002/hep.23294/fullhttp://www.ncbi.nlm.nih.gov/pubmed/20101749?tool=bestpractice.com
推荐定期检查以评估是否缺乏脂溶性维生素。
对肝硬化基础上肝癌的筛查包括每6到12个月检查腹部超声和血清甲胎蛋白。
对于甲型病毒性肝炎和乙型病毒性肝炎的血清抗体筛查很重要,如果没有证据表明既往感染或接受过免疫接种的人群可进行免疫接种。
合并炎症性肠病(IBD)患者由于发生结直肠癌的风险很大,应定期进行结肠镜检查。[39]Vleggaar FP, Lutgens MW, Claessen MM, et al. Review article: the relevance of surveillance endoscopy in long-lasting inflammatory bowel disease. Aliment Pharmacol Ther. 2007;26(suppl 2):47-52.http://www.ncbi.nlm.nih.gov/pubmed/18081648?tool=bestpractice.com[25]Chapman R, Fevery J, Kalloo A, et al. Diagnosis and management of primary sclerosing cholangitis. Hepatology. 2010;51:660-678.http://onlinelibrary.wiley.com/doi/10.1002/hep.23294/fullhttp://www.ncbi.nlm.nih.gov/pubmed/20101749?tool=bestpractice.com[80]Boonstra K, Weersma RK, van Erpecum KJ, et al. Population-based epidemiology, malignancy risk and outcome of primary sclerosing cholangitis. Hepatology. 2013;58:2045-2055.http://www.ncbi.nlm.nih.gov/pubmed/23775876?tool=bestpractice.com