重症酒精性肝炎与慢加急性肝衰竭

孙福荣; 王炳元

doi:10.3969/j.issn.1001-5256.2019.03.008

重症酒精性肝炎与慢加急性肝衰竭

DOI: 10.3969/j.issn.1001-5256.2019.03.008

中国医科大学附属第一医院老年消化科

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中图分类号: R575.1;R575.3
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出版历程
- 出版日期: 2019-03-20

Severe alcoholic hepatitis and acute-on-chronic liver failure

Department of Elderly Gastroenterology, the First Hospital of China Medical University

摘要

摘要:
酒精性肝炎（AH）患者出现以快速进展或加重的黄疸、凝血异常及肝脏相关并发症等为主的表现,往往提示发生重症AH的可能。在感染、大量饮酒等诱因的作用下,部分患者短期内病情迅速进展,不仅导致肝功能急性失代偿,并且出现以器官功能衰竭和较高的28 d病死率等为主要特征的慢加急性肝衰竭（ACLF）。早期识别ACLF并予以有效干预能够改善预后。肠道屏障功能障碍与肝-肠轴失衡在重症AH和ACLF的发展中发挥重要作用。应积极改善患者的营养状态,但药物治疗对改善ACLF病情和预后的作用有限。早期肝移植能够为患者带来更多获益。
- 肝炎,酒精性 /
- 慢加急性肝衰竭 /
- 病理过程 /
- 危险性评估 /
- 治疗学
Abstract:
Rapid progression or aggravation of jaundice, coagulation abnormalities and liver-related complications in patients with alcoholichepatitis indicates that they may develop severe alcoholic hepatitis. Some of these patients can progress acute-on-chronic liver failure withacute insults, such as infection and binge drinking and binge, showing as acute decompensation, organ failure and high 28-day mortalityrate. Early identification and effective intervention can improve the prognosis of acute-on-chronic liver failure. Intestinal barrier dysfunc-tion and liver-gut axis imbalance play an important role in the development of severe alcoholic hepatitis and acute-on-chronic liver fail-ure. It is important to improve the basic nutritional status of patients. Effective drug therapies are limited in improving the condition andprognosis of acute-on-chronic liver failure. Early liver transplantation can bring great benefits to these patients.
- hepatitis, alcoholic /
- acute-on-chronic liver failure /
- pathologic processes /
- risk assessmen /
- therapeutics

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