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Establishment of the diagnostic criteria and hierarchical diagnosis and treatment system for acute-on-chronic liver failure based on high-quality Chinese evidence
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摘要: 建立一个由中国临床证据支持的慢性肝病急性加重患者分层诊疗体系,以及通过高质量中国循证证据制订适合HBV高流行区慢加急性肝衰竭(ACLF)诊断标准是中国在重肝领域取得突破、发出中国声音的重大机会。以肝脏疾病为原发病伴(肝硬化及非酒精性脂肪性肝炎)及不伴(慢性乙型肝炎非肝硬化)全身器官受损的患者是否可以使用同一种标准诊断ACLF,这是关于制订HBV高流行区ACLF诊断标准的关键。对与欧洲、南美洲慢(加急)性肝衰竭联盟进行全球合作的中国慢(加急)性肝衰竭联盟在上述方面开展的工作进行了介绍。Abstract: Establishment of a hierarchical diagnosis and treatment system for patients with acute exacerbation of chronic liver diseases based on Chinese clinical evidence and development of the diagnostic criteria for acute-on-chronic liver failure ( ACLF) in HBV epidemic areas based on high-quality Chinese evidence provide great opportunities for China to make breakthroughs in the field of severe liver diseases and utter the Chinese voice around the world. Whether the same diagnostic criteria for ACLF can be used in patients with liver diseases as primary diseases with ( liver cirrhosis and nonalcoholic steatohepatitis) or without ( non-cirrhotic chronic hepatitis B) systemic organ injury is the key to the development of the diagnostic criteria for ACLF in HBV epidemic areas. This article introduces the global cooperation between EASL-CLIF Consortium, South America CLIF Consortium, and Chinese CLIF Consortium.
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Key words:
- acute-on-chronic liver failure /
- diagnosis /
- reference standards /
- critical pathways
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[1] ZHOU M, WANG H, ZENG X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017:A systematic analysis for the Global Burden of Disease Study 2017[J].Lancet, 2019.[Epub ahead of print] [2] GU WY, XU BY, ZHENG X, et al. Acute-on-chronic liver failure in China:Rationale for developing a patient registry and baseline characteristics[J]. Am J Epidemiol, 2018, 187 (9) :1829-1839. [3] 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. [4] 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. -
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