急性肝衰竭的治疗进展

骆玲; 张琼方; 张大志

doi:10.3969/j.issn.1001-5256.2018.02.049

急性肝衰竭的治疗进展

DOI: 10.3969/j.issn.1001-5256.2018.02.049

重庆医科大学附属第二医院感染疾病科

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中图分类号: R575.3
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出版历程
- 出版日期: 2018-02-20

Advances in the treatment of acute liver failure

Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University

摘要

摘要:
急性肝衰竭(ALF)是一种罕见的危及生命的疾病,病情发展迅速并影响多个器官系统功能,生存率低。早期识别病因及保护重要脏器功能对生存至关重要。近年来,随着人工肝、干细胞移植及肝移植技术不断发展,ALF疗效有明显提高。主要从ALF的病因和累及的主要器官系统两大方面阐述了ALF的治疗,并介绍了人工肝及干细胞移植的最新进展。
- 肝功能衰竭,急性 /
- 治疗 /
- 综述
Abstract:
Acute liver failure (ALF) is a rare life-threatening disease with rapid progression and a low survival rate and affects the function of multiple organ systems.Early identification of cause and protection of vital organs are critical for patients' survival.With the development in artificial liver, stem cell transplantation, and liver transplantation in recent years, the outcome of ALF has been greatly improved.This article elaborates on the treatment of ALF from the aspects of the etiology of ALF and major organ systems involved and introduces the latest advances in artificial liver and stem cell transplantation.
- liver failure, acute /
- therapy /
- review

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参考文献(61)

[1] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Disease, CMA;Severe Liver Disease and Artificial Liver Group, Chinese of Hepatology, CMA.Guideline for diagnosis and treatment of liver failure[J].Chin J Clin Infect Dis, 2012, 5 (6) :321-327. (in Chinese) 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 (2012年版) [J].中华临床感染病杂志, 2012, 5 (6) :321-327.

[2]SARIN SK, KEDRISETTY CK, ABBAS Z, et al.Acute-onchronic liver failure:consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014[J].Hepatol Int, 2014, 8 (4) :453-471.

[3]PUNZALAN CS, BARRY CT.Acute liver failure:diagnosis and management[J].J Intensive Care Med, 2016, 31 (10) :642-653.

[4]CASTALDO ET, CHARI RS.Liver transplantation for acute hepatic failure[J].HPB (Oxford) , 2006, 8 (1) :29-34.

[5]LARSON AM, POLSON J, FONTANA RJ, et al.Acetaminophen-induced acute liver failure:results of a United States multicenter, prospective study[J].Hepatology, 2005, 42 (6) :1364-1372.

[6]STRAVITZ RT, KRAMER AH, DAVERN T, et al.Intensive care of patients with acute liver failure:recommendations of the US Acute Liver Failure Study Group[J].Crit Care Med, 2007, 35 (11) :2498-2508.

[7]POLSON J, LEE WM.AASLD position paper:the management of acute liver failure[J].Hepatology, 2005, 41 (5) :1179-1197.

[8]LEE WM, HYNAN LS, ROSSARO L, et al.Intravenous N-acetylcysteine improves transplant-free survival in early stage nonacetaminophen acute liver failure[J].Gastroenterology, 2009, 137 (3) :856-864.

[9]BERNAL W, AUZINGER G, DHAWAN A, et al.Acute liver failure[J].Lancet, 2010, 376 (9736) :190-201.

[10]CHEN TJ.Clinical features and relative prognosis factors of 56 patients with drug-induced liver failure[J].Northwest Pharm J, 2013, 28 (5) :518-520. (in Chinese) 陈天江.药物性肝衰竭的临床特点及预后有关因素分析[J].西北药学杂志, 2013, 28 (5) :518-520.

[11]TIAN MM, WANG XB, LI YR, et al.Clinical features and relative prognosis factors of 56 patients with drug-induced liver failure[J].Prog Mod Biomed, 2013, 13 (30) :5929-5933. (in Chinese) 田梅梅, 王宪波, 李蕴铷, 等.药物性肝衰竭临床特点及预后有关因素分析[J].现代生物医学进展, 2013, 13 (30) :5929-5933.

[12]Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association.Guidelines for the management of drug-induced liver injury[J].J Clin Hepatol, 2015, 31 (11) :1752-1769. (in Chinese) 中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志, 2015, 31 (11) :1752-1769.

[13]SCHIODT FV, DAVERN TJ, SHAKIL AO, et al.Viral hepatitis-related acute liver failure[J].Am J Gastroenterol, 2003, 98 (2) :448-453.

[14]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.

[15]European Association for the Study of the Liver.EASL clinical practice guidelines:management of chronic hepatitis B virus infection[J].J Hepatol, 2012, 57 (1) :167-185.

[16]AJMERA V, XIA G, VAUGHAN G, et al.What factors determine the severity of hepatitis A-related acute liver failure?[J].J Viral Hepat, 2011, 18 (7) :167-174.

[17]TAYLOR RM, DAVERN T, MUNOZ S, et al.Fulminant hepatitis A virus infection in the United States:incidence, prognosis, and outcomes[J].Hepatology, 2006, 44 (6) :1589-1597.

[18]JAYANTHI V, UDAYAKUMAR N.Acute liver failure in pregnancy:an overview[J].Minerva Gastroenterol Dietol, 2008, 54 (1) :75-84.

[19]FLAMM SL, YANG YX, SINGH S, et al.American Gastroenterological Association Institute Guidelines for the diagnosis and management of acute liver failure[J].Gastroenterology, 2017, 152 (3) :644-647.

[20]PETERS DJ, GREENE WH, RUGGIERO F, et al.Herpes simplexinduced fulminant hepatitis in adults[J].Dig Dis Sci, 2000, 45 (12) :2399-2404.

[21]MAHAJAN A, LAT I.Correction of coagulopathy in the setting of acute liver failure[J].Crit Care Nurs Clin North Am, 2010, 22 (3) :315-321.

[22]PEREIRA SP, ROWBOTHAM D, FITT S, et al.Pharmacokinetics and efficacy of oral versus intravenous mixed-micellar phylloquinone (vitamin K1) in severe acute liver disease[J].J Hepatol, 2005, 42 (3) :365-370.

[23]RAGHVAN M, MARIK PE.Therapy of intracranial hypertension in patients with fulminant hepatic failure[J].Neurocrit Care, 2006, 4 (2) :179-189.

[24]SHALIMAR, SUBRAT K, ACHARYA.Management in acute liver failure[J].J Clin Exp Hepatol, 2015, 5 (1) :104-115.

[25]JALAN R, O DAMINK SW, DEUTZ NE, et al.Moderate hypothermia for uncontrolled intracranial hypertension in acute liver failure[J].Lancet, 1999, 354 (9185) :1164-1168.

[26]KARVELLAS CJ, TODD STRAVITZ R, BATTENHOUSE H, et al.Therapeutic hypothermia in acute liver failure:a multicenter retrospective cohort analysis[J].Liver Transpl, 2015, 21 (1) :4-12.

[27]KARVELLAS CJ, FIX OK, BATTENHOUSE H, et al.Outcomes and complications of intracranial pressure monitoring in acute liver failure:a retrospective cohort study[J].Crit Care Med, 2014, 42 (5) :1157-1167.

[28]TUJIOS SR, HYNAN LS, VAZQUEZ MA, et al.Risk factors and outcomes of acute kidney injury in patients with acute liver failure[J].Clin Gastroenterol Hepatol, 2015, 13 (2) :352-359.

[29]HOSTE EA, SEHURGERS M.Epidemiology of acute kidney injury:how big is the problem[J].Crit Care Med, 2012, 36 (4) :146-151.

[30]CHOLONGITAS E, SHUSANG V, MARELLI L, et al.Renal function assessment in cirrhosis-difficulties and alternative measurements[J].Aliment Pharmacol Ther, 2007, 26 (7) :969-978.

[31]WEIR MR.Improving the estimating equation for GFR——a clinical perspective[J].N Engl J Med, 2012, 367 (7) :75-76.

[32]KANDIAH PA, OLSON JC, SUBRAMANIAN RM.Emerging strategies for the treatment of patients with acute hepatic failure[J].Curr Opin Crit Care, 2016, 22 (2) :142-151.

[33]BERNSMEIER C, ANTONIADES CG, WENDON J.What’s new in acute liver failure?[J].Intensive Care Med, 2014, 40 (10) :1545-1548.

[34]DHAREL N, BAJAJ JS.Antibiotic prophylaxis in acute liver failure:friend or foe?[J].Clin Gastroenterol Hepatol, 2014, 12 (11) :1950-1952.

[35]CHEN YM, ZHU JY, LI JG, et al.Therapeutic effects of plasma exchange combined with continuous hemodiafiltration on chronic severe hepatitis B-a report of 87 cases[J].New Med, 2008, 39 (1) :13-16. (in Chinese) 陈幼明, 朱建芸, 李建国, 等.血浆置换联合持续性血液滤过透析对慢性重型乙型病毒性肝炎临床症状及生化指标的影响——附87例报告[J].新医学, 2008, 39 (1) :13-16.

[36]HE GL, FENG L, DUAN CY, et al.Meta-analysis of survival with the molecular adsorbent recirculating system for liver failure[J].Int J Clin Exp Med, 2015, 8 (10) :17046-17054.

[37]SALIBA F, CAMUS C, DURAND F, et al.Albumin dialysis with a noncell artificial liver support device in patients with acute liver failurea randomized, controlled trial[J].Ann Intern Med, 2013, 159 (8) :522-531.

[38]RADEMACHER S, OPPERT M, JORRES A.Artificial extracorporeal liver support therapy in patients with severe liver failure[J].Expert Rev Gastroenterol Hepatol, 2011, 5 (5) :591-599.

[39]GLORIOSO JM, MAO SA, RODYSILL B, et al.Reply to:“Pivotal preclinical trial of the spheroid reservoir bioartificial liver”[J].J Hepatol, 2015, 63 (4) :1052-1053.

[40]MILLIS JM, CRONIN DC, JOHNSON R, et al.Initial experience with the modified extracorporeal liver-assist device for patients with fulminant hepatic failure:system modifications and clinical impact[J].Transplantation, 2002, 74 (12) :1735-1746.

[41]BAO J, LI Y, LI Y, et al.FRI-418-Evaluation of spheroid reservoir bioartificial liver with porcine hepatocytes in rhesus monkey model of acute liver failure[J].J Hepatol, 2017, 66 (1) :s338.

[42]ZHAO L, LI J, LV G, et al.Evaluation of a reversibly immortalized human hepatocyte line in bioartificial liver in pigs[J].Afr J Biotechnol, 2012, 11 (17) :4116-4126.

[43]LV G, ZHAO L, ZHANG A, et al.Bioartificial liver system based on choanoid fluidized bed bioreactor improve the survival time of fulminant hepatic failure pigs[J].Biotechnol Bioeng, 2011, 108 (9) :2229-2236.

[44]GAO YM, SUN LL, HUI LJ.Advances in research of bioartificial liver[J].Chin Bull Life Sci, 2016, 28 (8) :915-920. (in Chinese) 高义萌, 孙露露, 惠利健.生物人工肝研究进展[J].生命科学, 2016, 28 (8) :915-920.

[45]VOLAREVIC V, NURKOVIC J, ARSENIJEVIC N, et al.Concise review:therapeutic potential of mesenchymal stem cells for the treatment of acute liver failure and cirrhosis[J].Stem cells, 2014, 32 (11) :2818-2823.

[46]CAI JL, LIU YL, HU WJ, et al.Advances in mesenchymal stem cell transplan tation for liver failure[J].J Chongqing Uni Technol (Nat Sci) , 2012, 26 (2) :47-51. (in Chinese) 蔡家利, 刘永, 胡文君, 等.间充质干细胞治疗肝衰竭研究进展[J].重庆理工大学学报:自然科学, 2012, 26 (2) :47-51.

[47]CHRIST B, BRUCKNER S, WINKLER S.The therapeutic promise of mesenchymal stem cells for liver restoration[J].Trends Mol Med, 2015, 21 (11) :673-686.

[48]SHI D, ZHANG J, ZHOU Q, et al.Quantitative evaluation of human bone mesenchymal stem cells rescuing fulminant hepatic failure in pigs[J].Gut, 2017, 66 (5) :955-964.

[49]NAGAMOTO Y, TAKAYAMA K, OHASHI K, et al.Transplantation of a human i PSC-derived hepatocyte sheet increases survival in mice with acute liver failure[J].J Hepatol, 2016, 64 (5) :1068-1075.

[50]LEE HS, CHOI GH, JOO DJ, et al.Prognostic value of model for end-stage liver disease scores in patients with fulminant hepatic failure[J].Transplant Proc, 2013, 45 (8) :2992-2994.

[51]CHOLONGITAS E, THEOCHARIDOU E, VASIANOPOULOU P, et al.Comparison of the sequential organ failure assessment score with the King's College Hospital criteria and the model for end-stage liver disease score for the prognosis of acetaminophen-induced acute liver failure[J].Liver Transpl, 2012, 18 (4) :405-412.

[52]SU YH, LIN SY, SONG W, et al.DNA markers in molecular diagnostics for hepatocellular carcinoma[J].Expert Rev Mol Diagn, 2014, 14 (7) :803-817.

[53]MAIWAL R, KUMAR A, SARIN SK.Liver regeneration during acute-on-chronic liver failure using growth factors:in vivo or ex vivo indulgence of bone marrow?[J].Gastroenterology, 2013, 145 (4) :901-904.

[54]CAI ZX, CHEN XB, YAN LN, et al.Analysis of risk factors of initial poor graft function after living donor liver transplantation[J].Ogran Transplant, 2016, 7 (6) :444-448. (in Chinese) 蔡振兴, 陈晓波, 严律南, 等.活体肝移植术后早期移植物功能不良的危险因素分析[J].器官移植, 2016, 7 (6) :444-448.

[55]WANG JH, ZHAO Y, LI ZQ, et al.Application value of contrast enhanced ultrasound for postoperative monitoring after split liver transplantation[J].Ogran Transplant, 2017, 8 (6) :440-449. (in Chinese) 王建红, 赵扬, 李志强, 等.超声造影在劈离式肝移植术后监测的应用价值初探[J].器官移植, 2017, 8 (6) :440-449.

[56]O’GRADY J.Timing and benefit of liver transplantation in acute liver failure[J].J Hepatol, 2014, 60 (3) :663-670.

[57]JIANG T.Source of donor liver for liver transplantation:current status and related advances[J].World Latest Med Inform, 2016, 16 (78) :43-44. (in Chinese) 江涛.肝移植供肝来源的现状与进展[J].世界最新医学信息文摘, 2016, 16 (78) :43-44.

[58]SCHMIDT LE, LARSEN FS.MELD score as a predictor of liver failure and death in patients with acetaminophen-induced liver injury[J].Hepatology, 2007, 45 (3) :789-796.

[59]BAILEY B, AMRE DK, GAUDREAULT P.Fulminant hepatic failure secondary to acetaminophen poisoning:a systematic review and meta-analysis of prognostic criteria determining the need for liver transplantation[J].Crit Care Med, 2003, 31 (1) :299-305.

[60]FIGORILLI F, ROUX O, PUTIGNANO A, et al.CLIF-C ALF score is a new prognostic tool to identify liver transplant candidates in patients with paracetamol related acute liver failure and it can predict the futility of liver transplantation[J].J Hepatol, 2016, 64 (2) :s306-s307.

[61]ANASTASIOU OE, KALSCH J, HAKMOUNI M, et al.Low transferrin and high ferritin concentrations are associated with worse outcome in acute liver failure[J].Liver Int, 2017, 37 (7) :1032-1041.

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