Differences in the diagnostic criteria for acute-on-chronic liver failure between the East and the West
-
摘要: 慢加急性肝衰竭(ACLF)是危及全球公共健康的重大疾病,内科综合治疗病死率高达50%~90%,早期诊断和治疗对降低ACLF病死率至关重要。由于东西方国家ACLF主要病因不同,至今仍无统一的ACLF定义与诊断标准,有无肝硬化疾病基础是ACLF诊断标准的争议焦点。综述了近年来有关ACLF定义与诊断标准、诱因及发病机制的最新研究结果,为制订新的治疗策略和国际指南提供理论依据。Abstract: Acute-on-chronic liver failure ( ACLF) is a serious threat to global public health, with a mortality rate of as high as 50%-90% after comprehensive medical treatment, and early diagnosis and treatment are of vital importance to reducing the mortality rate of ACLF. Due to the difference in major etiologies of ACLF between the East and the West, there are still no universally accepted diagnostic criteria for ACLF, with controversies over whether the underlying disease of liver cirrhosis should be one of the diagnostic criteria for ACLF.This article reviews the latest research advances in the definition, diagnostic criteria, predisposing factors, and pathogenesis of ACLF, in order to provide a theoretical basis for the development of new treatment strategies and international guidelines.
-
Key words:
- acute-on-chronic liver failure /
- hepatitis B /
- liver cirrhosis /
- diagnosis /
- Asia /
- Europe /
- Americas
-
[1] WU T, LI J, SHAO L, et al. Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-onchronic liver failure[J]. Gut, 2018, 67 (12) :2181-2191. [2] HERNAEZ R, SOLA E, MOREAU R, et al. Acute-on-chronic liver failure:An update[J]. Gut, 2017, 66 (3) :541-553. [3] BERNAL W, JALAN R, QUAGLIA A, et al. Acute-on-chronic liver failure[J]. Lancet, 2015, 386 (10003) :1576-1587. [4] OHNISHI H, SUGIHARA J, MORIWAKI H, et al. Acute-onchronic liver failure[J]. Ryoikibetsu Shokogun Shirizu, 1995, 7:217-219. [5] JALAN R, WILLIAMS R. Acute-on-chronic liver failure:Pathophysiological basis of therapeutic options[J]. Blood Purif, 2002, 20 (3) :252-261. [6] 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, 1437. e1421-1429. [7] BAJAJ JS, O'LEARY JG, REDDY KR, et al. Survival in infectionrelated acute-on-chronic liver failure is defined by extrahepatic organ failures[J]. Hepatology, 2014, 60 (1) :250-256. [8] O’LEARY JG, REDDY KR, GARCIA-TSAO G, et al. NACSELD acute-on-chronic liver failure (NACSELD-ACLF) score predicts 30-day survival in hospitalized patients with cirrhosis[J]. Hepatology, 2018, 67 (6) :2367-2374. [9] 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. [10] 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. [11] 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.[Epub ahead of print] [12] 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. [13] CHOUDHURY A, JINDAL A, MAIWALL R, et al. Liver failure determines the outcome in patients of acute-on-chronic liver failure (ACLF) :Comparison of APASL ACLF research consortium (AARC) and CLIF-SOFA models[J]. Hepatol Int, 2017, 11 (5) :461-471. [14] 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, 中华医学会肝病学分会.病毒性肝炎防治方案[J].中华传染病杂志, 2001, 19 (1) :56-62. [15] 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. Diagnostic and treatment guidelines for liver failure[J]. Inter J Epidemiol Infect Dis, 2006, 33 (4) :217-221. (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.肝衰竭诊疗指南 (2006年版) [J].国际流行病学传染病学杂志, 2006, 33 (4) :217-221. [16] 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) [J]. J Clin Hepatol, 2019, 35 (1) :38-44. (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 (2018年版) [J].临床肝胆病杂志, 2019, 35 (1) :38-44. [17] YANG L, WU T, LI J, et al. Bacterial infections in acute-onchronic liver failure[J]. Semin Liver Dis, 2018, 38 (2) :121-133. [18] 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. [19] YIN S, WANG SJ, GU WY, et al. Risk of different precipitating events for progressing to acute-on-chronic liver failure in HBV-related cirrhotic patients[J]. J Dig Dis, 2017, 18 (5) :292-301. [20] FERNANDEZ J, ACEVEDO J, WEIST R, et al. Bacterial and fungal infections in acute-on-chronic liver failure:Prevalence, characteristics and impact on prognosis[J]. Gut, 2018, 67 (10) :1870-1880. [21] 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. [22] ZHANG DJ, ZHOU B, HOU JL. Research progress in prognostic models of acute-on-chronic liver failure[J]. J Clin Hepatol, 2018, 34 (6) :1351-1356. (in Chinese) 张东敬, 周彬, 侯金林.慢加急性肝衰竭预后模型的研究进展[J].临床肝胆病杂志, 2018, 34 (6) :1351-1356. [23] MACDONALD S, ANDREOLA F, BACHTIGER P, et al. Cell death markers in patients with cirrhosis and acute decompensation[J]. Hepatology, 2018, 67 (3) :989-1002. [24] CLARIA J, STAUBER RE, COENRAAD MJ, et al. Systemic inflammation in decompensated cirrhosis:Characterization and role in acute-on-chronic liver failure[J]. Hepatology, 2016, 64 (4) :1249-1264. [25] LI J, LI J, CHEN X, et al. Defining the molecular basis of hepatitis B virus-related acute-on-chronic liver failure by transcriptome sequencing of patient peripheral blood mononuclear cells[J]. Hepatology, 2018, 68:191A.
本文二维码
计量
- 文章访问数: 1742
- HTML全文浏览量: 66
- PDF下载量: 452
- 被引次数: 0