What Is Chronic Fibrosis?

Liver fibrosis is a pathophysiological process, which refers to abnormal proliferation of connective tissue in the liver caused by various pathogenic factors. Any liver injury has liver fibrosis in the process of liver repair and healing. If the damage factor cannot be removed for a long time, the fibrosis process will continue to develop into cirrhosis for a long time. Therefore it is not an independent disease.

Basic Information

English name: liver fibrosis
Visiting department: Gastroenterology
Multiple groups: Chronic hepatitis and chronic alcoholics

Common locations: liver
Common causes: Viral hepatitis, alcoholic liver, fatty liver, autoimmune diseases, etc.
Common symptoms: Fatigue, loss of appetite, indigestion, bleeding, etc.

Causes of liver fibrosis

There are many causes of liver fibrosis, and viral hepatitis, alcoholic liver, fatty liver, and autoimmune diseases are more common in clinical practice.

Clinical manifestations of liver fibrosis

Strictly speaking, liver fibrosis does not have any clinical symptoms, mainly due to various factors that damage the liver and cause clinical symptoms of hepatitis or further aggravate liver cirrhosis, the main manifestations are as follows:

Fatigued

2. loss of appetite

Sometimes with nausea and vomiting.

3. Chronic indigestion

Flatulence, constipation or diarrhea, and pain in the liver. Clinically, some patients have no obvious history of chronic liver disease and were found after further examination.

4. Chronic gastritis

Many patients with chronic hepatitis develop symptoms such as acid reflux, belching, hiccups, epigastric pain, and abdominal fullness.

5. bleeding

Chronic hepatitis affects the synthesis of prothrombin and other coagulation factors due to liver failure. Clinical manifestations of liver fibrosis often include spider moles, epistaxis, bleeding gums, purple spots or bleeding spots on the skin and mucous membranes, and women often have more menstrual periods. The above symptoms often indicate that the liver fibers have developed to the stage of cirrhosis.

Diagnosis of liver fibrosis

So far, there is no specific clinical diagnostic method for liver fibrosis. Imaging examination including ultrasound, CT and liver ultrasound can provide clues in this regard. The four tests of liver fibrosis are not specific because they are greatly affected by the inflammation of the liver and are for clinical reference only. The introduction is as follows:

1. PC (type collagen)

It reflects the synthesis of type collagen in the liver, the serum content is consistent with the degree of liver fibrosis, and it is significantly related to the serum -globulin level. PC is closely related to the degree of liver fibrosis, but it is not specific. PC also increased during fibrosis of other organs. Patients with chronic hepatitis with persistently elevated PC suggest that the disease progresses to liver cirrhosis, and a reduction in PC to normal may indicate remission. This shows that PC is not only valuable in the early diagnosis of liver fibrosis, but also meaningful in judging the prognosis of chronic liver disease.
Serum PC levels are closely related to the degree of liver fibrosis lesions, reflecting liver fibrosis and inflammatory activity, which are significantly increased in the early stage, while patients with old liver cirrhosis and some advanced liver cirrhosis and liver atrophy do not necessarily increase serum PC.

2. -C (type IV collagen)

In order to constitute the main component of the basement membrane, it reflects the collagen renewal rate of the basement membrane. The increase in content can more sensitively reflect the process of liver fibrosis, which is one of the early signs of liver fibrosis.

(1) It appears earliest in liver fibrosis and is suitable for early diagnosis of liver fibrosis.

(2) It can reflect the degree of liver fibrosis. With the evolution of chronic hepatitis cirrhosis liver cancer, IV-C collagen content gradually increases in serum.

3.LN (Laminin)

It is a unique non-collagenous structural protein in the basement membrane, which is positively correlated with the degree of liver fibrosis activity and portal vein pressure. It is significantly increased in slow-lived liver and liver cirrhosis and primary liver cancer. LN can also reflect the progress and severity of liver fibrosis. In addition, the higher the LN level, the more pronounced the esophageal varices in patients with cirrhosis.

(1) It reflects that liver fibrosis is normal. The liver interstitial contains a small amount of LN. During liver fibrosis and cirrhosis, myofibroblasts increase a large number of interstitial components such as collagen and LN are synthesized and secreted a complete basement membrane is formed Capillaryization). Sinus capillary sclerosis is a characteristic pathological change of liver cirrhosis. LN is positively correlated with the degree of fibrosis and portal hypertension, and it is particularly significant in the later stage of fibrosis.

(2) Related to tumor invasion and metastasis Cancer metastasis must first break through the basement membrane, so LN is related to tumor invasion and metastasis. Most tumor patients have elevated serum LN levels, especially breast cancer, lung cancer, colon cancer, and gastric cancer.

(3) Related to basement membrane-related diseases. For example, the serum of pregnant women with preeclampsia is significantly higher than that of normal pregnancy, suggesting that it may be related to glomerular and placental spiral artery damage. Serum LN is related to diseases such as diabetes and glomerulosclerosis.

4.HA (Hyaluronidase)

As one of the matrix components, it is synthesized by interstitial cells, which can more accurately and sensitively reflect the amount of fibrous tissue generated in the liver and the damage of liver cells. Sensitive indicators of liver fibrosis and cirrhosis.

(1) Serum HA increased slightly in acute liver and slow-moving liver, significantly increased in slow-lived liver, and extremely increased in liver cirrhosis.

(2) The serum HA of patients with liver cirrhosis is extremely high.

Liver fibrosis treatment

Anti-hepatic fibrosis treatment mainly includes the removal of pathogenic factors according to the primary disease, such as anti-hepatitis B, hepatitis C virus treatment, anti-schistosomiasis treatment, alcohol withdrawal, etc. Treatment for liver fibrosis itself, such as by inhibiting inflammation or lipid peroxidation, or inhibiting the proliferation of liver stellate cells, and promoting collagen degradation.

Liver fibrosis prevention

Emotional stability

The liver is very closely related to mental sentiment. Poor mood, depression, anger, and agitation can all affect liver function and accelerate the development of lesions. To be cheerful, to cheer up, to eliminate the burden of thought, and to help improve the condition.

2. Actively treat liver inflammation

Various factors lead to liver damage. During the inflammatory active period, we must pay attention to liver protection and anti-inflammatory treatment. If necessary, we should be hospitalized. Do not take it lightly because of mild or no symptoms, control inflammation in the shortest time, and avoid liver fibrosis.

During the stable period of the disease, you can do some light work or proper activities, and perform useful physical exercises, such as walking, doing aerobics, playing Tai Chi, and practicing qigong. The amount of activity is measured without feeling fatigue.

3. Simplified medication

Blind and excessive abuse of general drugs will increase the burden on the liver and is not conducive to liver recovery. Drugs that are harmful to the liver, such as isoniazid and barbiturates, should be used with caution or taboo.

4. Quit smoking and drinking

Long-term drinking, especially hard alcohol, can cause alcoholic cirrhosis. Therefore, drinking can make patients with liver cirrhosis worse and easily cause bleeding. Long-term smoking is not conducive to the stability and recovery of liver disease, can speed up the process of liver cirrhosis, and may promote the risk of liver cancer.