慢加急性肝衰竭的诊断标准比较及预后判断模型进展

刘娟; 白飞云; 张晶

doi:10.3969/j.issn.1001-5256.2019.06.046

慢加急性肝衰竭的诊断标准比较及预后判断模型进展

DOI: 10.3969/j.issn.1001-5256.2019.06.046

1. 鄂尔多斯第二人民医院肝病科
2. 北京佑安医院丙肝与中毒性肝病科

详细信息

中图分类号: R575.3
计量
- 文章访问数: 1572
- HTML全文浏览量: 29
- PDF下载量: 258
- 被引次数: 0
出版历程
- 收稿日期: 2018-11-30
- 出版日期: 2019-06-20

Research advances in diagnostic criteria for acute-on-chronic liver failure and models for prognostic evaluation

Department of Hepatology, Erdos Second People's Hospital

摘要

摘要: 慢加急性肝衰竭是在慢性肝病基础上出现严重急性肝功能失代偿,近期病死率极高,一直是肝病领域的研究热点。近年来中国、亚太和欧洲肝病学会分别出台或更新了慢加急性肝衰竭的诊断标准,但因东西方患者病因不同、发病机制不同导致诊断标准差异巨大。基于不同的诊断标准,预后判断模型也不断更新。对比了上述诊断标准并分析其共同点及差异,同时对新的预后判断模型进行详细的介绍,以便临床医生更好地理解和诊治该疾病。
- 慢加急性肝功能衰竭 /
- 诊断 /
- 预后 /
- 综述
Abstract: Acute-on-chronic liver failure is a serious acute liver function decompensation based on chronic liver diseases. It has an extremely high short-term mortality rate and has always been a research hotspot in the field of liver disease. In recent years, China, Asian Pacific Association for the Study of the Liver, and European Association for the Study of the Liver have issued or updated the diagnostic criteria for acute-on-chronic liver failure, but the diagnostic criteria vary greatly due to different etiologies and pathogeneses in the East and the West. Prognostic models have also been constantly updated based on different diagnostic criteria. This article compares the above diagnostic criteria and introduces the new prognostic models in detail, in order to improve the understanding and diagnosis/treatment of this disease among clinicians.
- acute-on-chronic liver failure /
- diagnosis /
- prognosis /
- review

HTML全文

参考文献(26)

[1]MOREAU R, JALAN R, GINES P, et al.Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis[J].Gastroenterology, 2013, 144 (7) :1426-1437.

[2]LIU H, CHEN G, GAN XM.Research advances in new approaches to treatment of acute-on-chronic liver failure[J].JClin Hepatol, 2015, 31 (9) :1496-1500. (in Chinese) 刘洪, 陈刚, 甘雪梅.慢加急性肝衰竭治疗的新技术及其研究进展[J].临床肝胆病杂志, 2015, 31 (9) :1496-1500.

[3]GARG H, KUMAR A, GARG V, et al.Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure[J].Dig Liver Dis, 2012, 44 (2) :166-171.

[4]WLODZIMIROW KA, ESLAMI S, ABU-HANNA A, et al.Asystematic review on prognostic indicators of acute on chronic liver failure and their predictive value for mortality[J].Liver Int, 2013, 33 (1) :40-52.

[5]Chinese Society of Infectious Diseases and Parasitology, Chinese Society of Hepatology, Chinese Medical Association.Prevention and treatment of viral hepatitis[J].Chin J Infect Dis, 2001, 19 (1) :56-62. (in Chinese) 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华传染病杂志, 2001, 19 (1) :56-62.

[6] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association;Severe Liver Diseases and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association.Guidelines for diagnosis and treatment 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.

[7]SARIN SK, KUMAR A, ALMEIDA JA, et al.Acute-on-chronic liver failure:Consensus recommendations of the Asian Pacific Association for the study of the liver (APASL) [J].Hepatol Int, 2009, 3 (1) :269-282.

[8]SARIN SK, KEDARISETTY 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.

[9]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.

[10]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.

[11]GALBOIS A, DAS V, CARBONELL N, et al.Prognostic scores for cirrhotic patients admitted to an intensive care unit:Which consequences for liver transplantation?[J].Clin Res Hepatol Gastroenterol, 2013, 37 (5) :455-466.

[12]KAMATH PS, KIM WR.The model for end-stage liver disease (MELD) [J].Hepatology, 2007, 45 (3) :797-805.

[13]BIGGINS SW, KIM WR, TERRAULT NA, et al.Evidencebased incorporation of serum sodium concentration into MELD[J].Gastroenterology, 2006, 130 (6) :1652-1660.

[14] PUGH RN, MURRAY-LYON IM, DAWSON JL, et al.Transection of the oesophagus for bleeding oesophageal varices[J].Br J Surg, 1973, 60 (8) :646-649.

[15]VINCENT JL, MORENO R, TAKALA J, et al.The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure.On behalf of the working group on sepsisrelated problems of the European society of intensive care medicine[J].Intensive Care Med, 1996, 22 (7) :707-710.

[16] FERREIRA FL, BOTA DP, BROSS A, et al.Serial evaluation of the SOFA score to predict outcome in critically ill patients[J].JAMA, 2001, 286 (14) :1754-1758.

[17]KARVELLAS CJ, PINK F, MCPHAIL M, et al.Bacteremia, acute physiology and chronic health evaluation II and modified end stage liver disease are independent predictors of mortality in critically ill nontransplanted patients with acute on chronic liver failure[J].Crit Care Med, 2010, 38 (1) :121-126.

[18]HERNAEZ R, SOLA E, MOREAU R, et al.Acute-on-chronic liver failure:An update[J].Gut, 2017, 66 (3) :541-553.

[19]XIANG-HUI Y, LANG X, YAN Z, et al.Prediction of prognosis to lamivudine in patients with spontaneous reactivation of hepatitis B virus-related acute-on-chronic liver failure:U-sing virologic response at week 4[J].Eur J Intern Med, 2014, 25 (9) :860-864.

[20]LIU XH, LI M, GUO HQ, et al.Dynamic changes of MELDscores can predict the prognosis of HBV-related acute-on-chronic liver failure[J].Infect Dis Info, 2014, 27 (2) :78-81. (in Chinese) 刘晓慧, 李铭, 郭海清, 等.动态MELD评分有助于预测HBV相关慢加急性肝衰竭预后[J].传染病信息, 2014, 27 (2) :78-81.

[21] WU T, 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.

[22] CHOLONGITAS EB, BETROSSIAN A, LEANDRO G, et al.King's criteria, APACHE II, and SOFA scores in acute liver failure[J].Hepatology, 2006, 43 (4) :881, 882.

[23]JALAN R, SALIBA F, PAVESI M, et al.Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure[J].J Hepatol, 2014, 61 (5) :1038-1047.

[24]SHI Y, YANG Y, HU Y, et al.Acute-on-chronic liver failure precipitated by hepatic injury is distinct from that precipitated by extrahepatic insults[J].Hepatology, 2015, 62 (1) :232-242.

[25]GUSTOT T, FERNANDEZ J, GARCIA E, et al.Clinical course of acute-on-chronic liver failure syndrome and effects on prognosis[J].Hepatology, 2015, 62 (1) :243-252.

[26]XU TJ, LYU S, YOU SL, et al.Clinical features and typing of hepatitis B virus-related acute-on-chronic liver failure based on recommendations of the World Congress of Gastroenterology[J].J Clin Hepatol, 2018, 34 (3) :548-552. (in Chinese) 徐天娇, 吕飒, 游绍莉, 等.基于世界胃肠病学大会提议的HBV相关慢加急性肝衰竭的临床特征及分型探讨[J].临床肝胆病杂志, 2018, 34 (3) :548-552.

施引文献

资源附件(0)

访问统计