关键词: 非病毒性慢性肝损伤, 病因, 诊断路径

Abstract: Objective To analyze the etiology and diagnostic methods of non-viral chronic liver injury and explore the clinical diagnostic pathways. Methods Clinical data of 356 patients with non-viral chronic liver injury admitted to the First Affiliated Hospital of Guangxi Medical University from June 2020 to December 2022 were collected in this study. Results The common causes of non-viral chronic liver injury were autoimmune liver disease (AILD) in 71 cases (19.9%), non-alcoholic fatty liver disease (NAFLD) in 64 cases (18.0%), and alcoholic liver disease (ALD) in 57 cases (16.0%); the main diagnostic methods were medical history (26.5%), liver biopsy (25.5%), and imaging examinations (15.5%). Based on the common types of diseases and the operability of examination, the following clinical diagnosis path were summarized: first-line screening: ① medical history collection and physical examination; ② liver function; ③ liver tropic and non-liver tropic virus screening; ④ autoimmune antibody; ⑤ immunoglobulin; ⑥ blood lipid; ⑦ abdominal ultrasound; second-line screening: ① rare etiology; ② thyroid function; ③ blood ceruloplasmin and K-F ring; ④ liver CT / MRI; third-line screening: ① genetic test; ② liver biopsy. For patients with weak second-line or third-line screening intention, we can follow up first and observe whether the liver function can be improved after taking special drugs, drinking abstinence, diet control, deworming or treatment of the primary disease. If improved, it will be related to the above situation. Conclusion AILD, NAFLD and ALD are common causes of non-viral chronic liver injury. The diagnostic pathway for non-viral chronic liver injury shows high diagnostic efficacy, is simple to implement, and is worthy of clinical promotion on a trial basis.

Key words: Non-viral chronic liver injury, Etiology, Diagnostic path