《肝衰竭诊治指南（2024年版）》解读

韩涛

doi:10.12449/JCH241207

《肝衰竭诊治指南（2024年版）》解读

DOI: 10.12449/JCH241207

韩涛^, ,

南开大学人民医院，天津市人民医院，天津 300121

利益冲突声明：本文不存在任何利益冲突。

详细信息

通信作者:
韩涛， hantaomd@126.com （ORCID： 0000-0003-4216-6968）

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出版历程
- 收稿日期: 2024-11-28
- 录用日期: 2024-12-06
- 出版日期: 2024-12-25

Interpretation of guideline for diagnosis and treatment of liver failure （2024 version）

Tao HAN^{,
,}

Tianjin Union Medical Center，Nankai University，Tianjin People’s Hospital，Tianjin 300121，China

More Information

Corresponding author: HAN Tao， hantaomd@126.com （ORCID： 0000-0003-4216-6968）

摘要

摘要: 2024年中华医学会感染病学分会肝衰竭与人工肝学组和中华医学会肝病学分会重型肝病与人工肝学组对我国《肝衰竭诊治指南（2018年版）》进行了更新。‍ ‍《肝衰竭诊治指南（2024年版）》涵盖肝衰竭的定义和病因、肝衰竭的分类和诊断、肝衰竭的治疗、展望4个方面的内容。本文对新版指南更新的要点进行解读，以期更好地指导肝衰竭的临床诊疗。
- 肝功能衰竭 /
- 诊断 /
- 治疗学 /
- 诊疗准则（主题）
Abstract: In 2024， Liver Failure and Artificial Liver Group， Chinese Society of Infectious Diseases， Chinese Medical Association and Chinese Society of Hepatology， Chinese Medical Association updated Guideline for diagnosis and treatment of liver failure （2018 version）. Guideline for diagnosis and treatment of liver failure （2024 version） covers the definition and etiology of liver failure， the classification and diagnosis of liver failure， the treatment of liver failure， and future prospects. This article gives an interpretation of the updated key points in the new edition of the guideline， in order to better guide the management of liver failure in clinical practice.
- Liver Failure /
- Diagnosis /
- Therapeutics /
- Practice Guidelines as Topic

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参考文献(24)

[1]	Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018 version)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
[2]	Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2024 version)[J]. J Clin Hepatol, 2024, 40( 12): 2371- 2387. DOI: 10.12449/JCH241206. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2024年版)[J]. 临床肝胆病杂志, 2024, 40( 12): 2371- 2387. DOI: 10.12449/JCH241206.
[3]	European Association for the Study of the Liver. EASL clinical practical guidelines on the management of acute(fulminant) liver failure[J]. J Hepatol, 2017, 66( 5): 1047- 1081. DOI: 10.1016/j.jhep.2016.12.003.
[4]	SHINGINA A, MUKHTAR N, WAKIM-FLEMING J, et al. Acute liver failure guidelines[J]. Am J Gastroenterol, 2023, 118( 7): 1128- 1153. DOI: 10.14309/ajg.0000000000002340.
[5]	WU TZ, LI J, SHAO L, et al. Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure[J]. Gut, 2018, 67( 12): 2181- 2191. DOI: 10.1136/gutjnl-2017-314641.
[6]	SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: Consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL): An update[J]. Hepatol Int, 2019, 13( 4): 353- 390. DOI: 10.1007/s12072-019-09946-3.
[7]	European Association for the Study of the Liver. EASL clinical practice guidelines on acute-on-chronic liver failure[J]. J Hepatol, 2023, 79( 2): 461- 491. DOI: 10.1016/j.jhep.2023.04.021.
[8]	BAJAJ JS, O’LEARY JG, REDDY KR, et al. Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures[J]. Hepatology, 2014, 60( 1): 250- 256. DOI: 10.1002/hep.27077.
[9]	JALAN R, YURDAYDIN C, BAJAJ JS, et al. Toward an improved definition of acute-on-chronic liver failure[J]. Gastroenterology, 2014, 147( 1): 4- 10. DOI: 10.1053/j.gastro.2014.05.005.
[10]	BAJAJ JS, O’LEARY JG, LAI JC, et al. Acute-on-chronic liver failure clinical guidelines[J]. Am J Gastroenterol, 2022, 117( 2): 225- 252. DOI: 10.14309/ajg.0000000000001595.
[11]	KARVELLAS CJ, BAJAJ JS, KAMATH PS, et al. AASLD practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis[J]. Hepatology, 2024, 79( 6): 1463- 1502. DOI: 10.1097/HEP.0000000000000671.
[12]	ZHANG Q, LI Y, HAN T, et al. Comparison of current diagnostic criteria for acute-on-chronic liver failure[J]. PLoS One, 2015, 10( 3): e0122158. DOI: 10.1371/journal.pone.0122158.
[13]	KULKARNI AV, SARIN SK. Acute-on-chronic liver failure-steps towards harmonization of the definition![J]. J Hepatol, 2024, 81( 2): 360- 366. DOI: 10.1016/j.jhep.2024.03.036.
[14]	QIU ST, ZHANG Q, HU JX, et al. Impact of onset time, number, type, and sequence of extrahepatic organ failure on prognosis of acute-on-chronic liver failure[J]. J Clin Transl Hepatol, 2024, 12( 3): 257- 265. DOI: 10.14218/JCTH.2023.00379.
[15]	YU ZJ, ZHANG Y, LI YH, et al. Development of a widely applicable and simple prognostic score for patients with acute-on-chronic liver failure[J]. J Clin Transl Hepatol, 2022, 10( 5): 867- 878. DOI: 10.14218/JCTH.2021.00328.
[16]	YU ZJ, ZHANG Y, CAO YY, et al. A dynamic prediction model for prognosis of acute-on-chronic liver failure based on the trend of clinical indicators[J]. Sci Rep, 2021, 11( 1): 1810. DOI: 10.1038/s41598-021-81431-0.
[17]	SUE MJ, LEE EW, SAAB S, et al. Transjugular liver biopsy: Safe even in patients with severe coagulopathies and multiple biopsies[J]. Clin Transl Gastroenterol, 2019, 10( 7): e00063. DOI: 10.14309/ctg.0000000000000063.
[18]	BLOOM PP, TAPPER EB, YOUNG VB, et al. Microbiome therapeutics for hepatic encephalopathy[J]. J Hepatol, 2021, 75( 6): 1452- 1464. DOI: 10.1016/j.jhep.2021.08.004.
[19]	CUNNINGHAM M, GUPTA R, BUTLER M. Checkpoint inhibitor hepatotoxicity: Pathogenesis and management[J]. Hepatology, 2024, 79( 1): 198- 212. DOI: 10.1097/HEP.0000000000000045.
[20]	MAIWALL R, SINGH SP, ANGELI P, et al. APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure[J]. Hepatol Int, 2024, 18( 3): 833- 869. DOI: 10.1007/s12072-024-10650-0.
[21]	Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Expert Commitee of Liver Failure and Arificial Liver, Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines on application of artificial liver blood purification system(version 2023)[J]. Chin J Clin Infect Dis, 2023, 16( 6): 401- 411. DOI: 10.3760/cma.j.issn.1674-2397.2023.06.001. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会感染病学分会肝衰竭与人工肝专家委员会. 人工肝血液净化系统治疗指南(2023年版)[J]. 中华临床感染病杂志, 2023, 16( 6): 401- 411. DOI: 10.3760/cma.j.issn.1674-2397.2023.06.001.
[22]	Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Expert consensus on clinical application of artificial liver and blood purification(2022 edition)[J]. J Clin Hepatol, 2022, 38( 4): 767- 775. DOI: 10.3969/j.issn.1001-5256.2022.04.007. 中华医学会肝病学分会重型肝病与人工肝学组. 人工肝血液净化技术临床应用专家共识(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 4): 767- 775. DOI: 10.3969/j.issn.1001-5256.2022.04.007.
[23]	European Association for the Study of the Liver. EASL clinical practice guidelines on liver transplantation[J]. J Hepatol, 2024, 81( 6): 1040- 1086. DOI: 10.1016/j.jhep.2024.07.032.
[24]	KIM DS, YOON YI, KIM BK, et al. Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation[J]. Hepatol Int, 2024, 18( 2): 299- 383. DOI: 10.1007/s12072-023-10629-3.