质子泵抑制剂在慢加急性肝衰竭治疗中的应用

姚俞昊; 夏潇; 张嘉鑫; 李小科; 叶永安

doi:10.3969/j.issn.1001-5256.2022.12.035

质子泵抑制剂在慢加急性肝衰竭治疗中的应用

DOI: 10.3969/j.issn.1001-5256.2022.12.035

姚俞昊^{1, 2},
夏潇³,
张嘉鑫^{2, 4},
李小科^{2, 4, , ,},
叶永安^{2, 4, , ,}

1.
北京中医药大学第一临床医学院，北京 100029
2.
北京中医药大学东直门医院消化科，北京 100700
3.
中国中医科学院广安门医院呼吸科，北京 100053
4.
北京中医药大学中医肝病研究院，北京 100700

基金项目:

国家自然科学基金 (82174341);

国家中医药管理局科研基金 (JDZX2015300);

北京中医药大学重点攻关项目 (2022-JYB-ZDGG-115)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：叶永安、李小科对研究思路、设计有关键贡献；姚俞昊、夏潇参与了研究数据的获取分析解释过程；姚俞昊起草论文；李小科、张嘉鑫对文章关键内容进行了修改。

详细信息

通信作者:
李小科，lixiaoke@vip.163.com

叶永安，yeyongan@vip.163.com

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出版历程
- 收稿日期: 2022-04-20
- 录用日期: 2022-05-24
- 出版日期: 2022-12-20

Application of proton pump inhibitors in acute-on-chronic liver failure

Yuhao YAO^{1, 2},
Xiao XIA³,
Jiaxin ZHANG^{2, 4},
Xiaoke LI^{2, 4
, ,
,},
Yong'an YE^{2, 4
, ,
,}

1.
The First Clinical Medical School, Beijing University of Chinese Medicine, Beijing 100029, China
2.
Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
3.
Department of Pneumology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
4.
Liver Diseases Academy of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100700, China

Research funding:

National Natural Science Foundation of China (82174341);

Scientific Research Projects of National Administration of Traditional Chinese Medicine (JDZX2015300);

Major Research Project of Beijing University of Chinese Medicine (2022-JYB-ZDGG-115)

More Information

Corresponding author: LI Xiaoke, lixiaoke@vip.163.com (ORCID: 0000-0002-1775-3063); YE Yong'an, yeyongan@vip.163.com (ORCID: 0000-0001-9765-4665)

摘要

摘要: 质子泵抑制剂(PPI)是临床常用药物，目前在慢加急性肝衰竭人群中广泛应用。然而这一用药现状未得到美国胃肠病学会最新慢加急性肝衰竭临床指南推荐支持。笔者结合国内外指南或共识，综合最新研究进展，以评述PPI在慢加急性肝衰竭人群中的使用指征、可能获益及潜在风险，以期为临床慢加急性肝衰竭人群规范使用PPI提供参考。
- 肝功能衰竭 /
- 质子泵抑制剂 /
- 治疗应用
Abstract: Proton pump inhibitors (PPIs) are commonly used in clinical practice and are currently widely used in people with acute-on-chronic liver failure (ACLF). However, such medication is still not supported by the recommendations in the latest version of Clinical guidelines for acute-on-chronic liver failure issued by American College of Gastroenterology. With reference to the guidelines or consensus statements in China and globally and the latest research advances, this article elaborates on the indications, possible benefits, and potential risks of PPIs used in people with ACLF, in order to provide a reference for the standardized use of PPIs in the population with ACLF in clinical practice.
- Liver Failure /
- Proton Pump Inhibitors /
- Therapeutic Uses

HTML全文

表 1 国内外肝衰竭指南对PPI应用的推荐意见

Table 1. Recommendations for PPI indications in domestic and international liver failure guidelines

项目	ACG指南^[6]	我国指南^[11]	EASL指南^[12]
推荐意见	(1)除非有明确适应证，避免使用PPI，因为会增加感染的风险。 (2)机械通气的人群可使用PPI预防应激性溃疡。	预防性使用H₂受体阻滞剂或PPI	(1)使用时应注意感染的风险。 (2)肠内营养建立时应考虑停用PPI。
证据依据人群	意见1：肝硬化意见2：ICU人群	消化性溃疡出血	非肝病人群

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