中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝硬化再代偿:现状与挑战

冯巩 宋娟娟 叶峰 马永红 任艺琳 张子怡 贺娜 李雪萍 弥曼

引用本文:
Citation:

肝硬化再代偿:现状与挑战

DOI: 10.3969/j.issn.1001-5256.2023.10.027
基金项目: 

2020陕西省教育厅课题 (20JK0343);

陕西省中医药管理局中医药传承创新暨“秦药”开发重点科学研究项目 ;

西安医学院2021年校级科研项目 (2021QN20)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:冯巩、宋娟娟、任艺琳、张子怡负责文献检索,资料分析,撰写论文;马永红、叶峰、贺娜参与修改论文;冯巩、弥曼、李雪萍负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    李雪萍, lxp86@163.com (ORCID: 0000-0002-0556-9728)

    弥曼, 853002274@qq.com (ORCID: 0000-0001-7408-5113)

Recompensation of liver cirrhosis: Current status and challenges

Research funding: 

‍2020 Shaanxi Provincial Department of Education project (20JK0343);

Key Scientific Research Project of Inheritance and Innovation of Traditional Chinese Medicine and Development of “Qin Medicine” by Shaanxi Provincial Administration of Traditional Chinese Medicine ;

Research Projects of Xi’an Medical College at University Level in 2021 (2021QN20)

More Information
    Corresponding author: LI Xueping,lxp86@163.com (ORCID: 0000-0002-0556-9728); MI Man,853002274@qq.com (ORCID: 0000-0001-7408-5113)
  • 摘要: 传统上,从代偿性肝硬化到失代偿性肝硬化的进展被认为是疾病自然史中的一个不可逆转点,然而,随着潜在病因的抑制、治愈与疾病消退,越来越多的新证据挑战了这一观点,“肝硬化再代偿”的观点逐渐被接受。近年来,关于肝硬化再代偿具体可行的定义及患者的临床特征引发国内外学者的不断探索。本文通过总结近期国内外对“肝硬化再代偿”的研究,整合已有观点并梳理研究证据,指出现阶段再代偿领域面临的挑战主要包括缺乏深层次的临床与基础研究、需定义非酒精性脂肪性肝病背景下的再代偿,以及面临的伦理方面的问题,为该领域未来的研究提供了新的探索方向。

     

  • [1] GRACIA-SANCHO J, MARRONE G, FERNÁNDEZ-IGLESIAS A. Hepatic microcirculation and mechanisms of portal hypertension[J]. Nat Rev Gastroenterol Hepatol, 2019, 16( 4): 221- 234. DOI: 10.1038/s41575-018-0097-3.
    [2] European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69( 2): 406- 460. DOI: 10.1016/j.jhep.2018.03.024.
    [3] XU XY, DING HG, LI WG, et al. Chinese guidelines on the management of liver cirrhosis(abbreviated version)[J]. World J Gastroenterol, 2020, 26( 45): 7088- 7103. DOI: 10.3748/wjg.v26.i45.7088.
    [4] EL-SHERIF O, JIANG ZG, TAPPER EB, et al. Baseline factors associated with improvements in decompensated cirrhosis after direct-acting antiviral therapy for hepatitis C virus infection[J]. Gastroenterology, 2018, 154( 8): 2111- 2121.e 8. DOI: 10.1053/j.gastro.2018.03.022.
    [5] TSOCHATZIS EA, BOSCH J, BURROUGHS AK. Liver cirrhosis[J]. Lancet, 2014, 383( 9930): 1749- 1761. DOI: 10.1016/S0140-6736(14)60121-5.
    [6] DE FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno Ⅶ-Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76( 4): 959- 974. DOI: 10.1016/j.jhep.2021.12.022.
    [7] SHARMA S, ROY A. Recompensation in cirrhosis: current evidence and future directions[J]. J Clin Exp Hepatol, 2023, 13( 2): 329- 334. DOI: 10.1016/j.jceh.2022.08.002.
    [8] ARAVINTHAN AD, BARBAS AS, DOYLE AC, et al. Characteristics of liver transplant candidates delisted following recompensation and predictors of such delisting in alcohol-related liver disease: a case-control study[J]. Transpl Int, 2017, 30( 11): 1140- 1149. DOI: 10.1111/tri.13008.
    [9] MACKEN L, GELSON W, PRIEST M, et al. Efficacy of direct-acting antivirals: UK real-world data from a well-characterised predominantly cirrhotic HCV cohort[J]. J Med Virol, 2019, 91( 11): 1979- 1988. DOI: 10.1002/jmv.25552.
    [10] SHEIKH NT, SHAUKAT MT, HUSSAIN A, et al. SVR achievement in triple therapy treated hepatitis C induced cirrhosis: A dual center retrospective cohort study[J]. Ann Med Surg(Lond), 2022, 80: 104193. DOI: 10.1016/j.amsu.2022.104193.
    [11] POSE E, TORRENTS A, REVERTER E, et al. A notable proportion of liver transplant candidates with alcohol-related cirrhosis can be delisted because of clinical improvement[J]. J Hepatol, 2021, 75( 2): 275- 283. DOI: 10.1016/j.jhep.2021.02.033.
    [12] GENTILE I, SCOTTO R, COPPOLA C, et al. Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort(Liver Network Activity-LINA cohort)[J]. Hepatol Int, 2019, 13( 1): 66- 74. DOI: 10.1007/s12072-018-9914-6.
    [13] JANG JW, CHOI JY, KIM YS, et al. Long-term effect of antiviral therapy on disease course after decompensation in patients with hepatitis B virus-related cirrhosis[J]. Hepatology, 2015, 61( 6): 1809- 1820. DOI: 10.1002/hep.27723.
    [14] RAO HY, WU N. Effect of nucleoside(acid) analogues on liver fibrosis in chronic hepatitis B[J]. Beijing Med, 2014, 36( 6): 421- 423. DOI: 10.15932/j.0253-9713.2014.06.013.

    饶慧瑛, 武楠. 核苷(酸)类似物长期治疗对慢性乙型肝炎肝纤维化的影响[J]. 北京医学, 2014, 36( 6): 421- 423. DOI: 10.15932/j.0253-9713.2014.06.013.
    [15] NIKOLAIDIS N, VASSILIADIS T, GIOULEME O, et al. Effect of lamivudine treatment in patients with decompensated cirrhosis due to anti-HBe positive/HBeAg-negative chronic hepatitis B[J]. Clin Transplant, 2005, 19( 3): 321- 326. DOI: 10.1111/j.1399-0012.2005.00340.x.
    [16] SHIM JH, LEE HC, KIM KM, et al. Efficacy of entecavir in treatment-naïve patients with hepatitis B virus-related decompensated cirrhosis[J]. J Hepatol, 2010, 52( 2): 176- 182. DOI: 10.1016/j.jhep.2009.11.007.
    [17] XU X, WANG H, ZHAO W, et al. Recompensation factors for patients with decompensated cirrhosis: a multicentre retrospective case-control study[J]. BMJ Open, 2021, 11( 6): e043083. DOI: 10.1136/bmjopen-2020-043083.
    [18] VILLANUEVA C, ALBILLOS A, GENESCÀ J, et al. Development of hyperdynamic circulation and response to β-blockers in compensated cirrhosis with portal hypertension[J]. Hepatology, 2016, 63( 1): 197- 206. DOI: 10.1002/hep.28264.
    [19] COSTA D, SIMBRUNNER B, JACHS M, et al. Systemic inflammation increases across distinct stages of advanced chronic liver disease and correlates with decompensation and mortality[J]. J Hepatol, 2021, 74( 4): 819- 828. DOI: 10.1016/j.jhep.2020.10.004.
    [20] VILLANUEVA C, ALBILLOS A, GENESCÀ J, et al. Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis[J]. J Hepatol, 2021, 75( 3): 589- 599. DOI: 10.1016/j.jhep.2021.04.022.
    [21] BEDOSSA P. Reversibility of hepatitis B virus cirrhosis after therapy: who and why[J]. Liver Int, 2015, 35 Suppl 1: 78- 81. DOI: 10.1111/liv.12710.
    [22] MØLLER S, BENDTSEN F. The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis[J]. Liver Int, 2018, 38( 4): 570- 580. DOI: 10.1111/liv.13589.
    [23] TREBICKA J, AMOROS A, PITARCH C, et al. Addressing profiles of systemic inflammation across the different clinical phenotypes of acutely decompensated cirrhosis[J]. Front Immunol, 2019, 10: 476. DOI: 10.3389/fimmu.2019.00476.
    [24] WANG Q, ZHAO H, DENG Y, et al. Validation of Baveno VII criteria for recompensation in entecavir-treated patients with hepatitis B-related decompensated cirrhosis[J]. J Hepatol, 2022, 77( 6): 1564- 1572. DOI: 10.1016/j.jhep.2022.07.037.
    [25] NABATCHIKOVA EA, ABDURAKHMANOV DT, ROZINA TP, et al. Delisting and clinical outcomes of liver transplant candidates after hepatitis C virus eradication: A long-term single-center experience[J]. Clin Res Hepatol Gastroenterol, 2021, 45( 6): 101714. DOI: 10.1016/j.clinre.2021.101714.
    [26] IWAKIRI Y, TREBICKA J. Portal hypertension in cirrhosis: Pathophysiological mechanisms and therapy[J]. JHEP Rep, 2021, 3( 4): 100316. DOI: 10.1016/j.jhepr.2021.100316.
    [27] SAAB S. Portal hypertension[J]. Clin Liver Dis, 2019, 23( 4):-. DOI: 10.1016/j.cld.2019.08.001.
    [28] VILLANUEVA C, ALBILLOS A, GENESCÀ J, et al. β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension(PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial[J]. Lancet, 2019, 393( 10181): 1597- 1608. DOI: 10.1016/S0140-6736(18)31875-0.
    [29] MONTEIRO S, GRANDT J, USCHNER FE, et al. Differential inflammasome activation predisposes to acute-on-chronic liver failure in human and experimental cirrhosis with and without previous decompensation[J]. Gut, 2021, 70( 2): 379- 387. DOI: 10.1136/gutjnl-2019-320170.
    [30] YANG L, KWON J, POPOV Y, et al. Vascular endothelial growth factor promotes fibrosis resolution and repair in mice[J]. Gastroenterology, 2014, 146( 5): 1339- 1350.e 1. DOI: 10.1053/j.gastro.2014.01.061.
    [31] SALEHI S, TAVABIE OD, VERMA S, et al. Serum microrna signatures in recovery from acute and chronic liver injury and selection for liver transplantation[J]. Liver Transpl, 2020, 26( 6): 811- 822. DOI: 10.1002/lt.25781.
    [32] REIBERGER T, HOFER BS. The Baveno VII concept of cirrhosis recompensation[J]. Dig Liver Dis, 2023, 55( 4): 431- 441. DOI: 10.1016/j.dld.2022.12.014.
    [33] MÉNDEZ-SÁNCHEZ N, PAL SC. New terms for fatty liver disease other than MAFLD: Time for a reality check[J]. J Hepatol, 2022, 77( 6): 1716- 1717. DOI: 10.1016/j.jhep.2022.08.009.
    [34] ASRANI SK, DEVARBHAVI H, EATON J, et al. Burden of liver diseases in the world[J]. J Hepatol, 2019, 70( 1): 151- 171. DOI: 10.1016/j.jhep.2018.09.014.
  • 加载中
计量
  • 文章访问数:  480
  • HTML全文浏览量:  237
  • PDF下载量:  132
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-03-24
  • 出版日期:  2023-10-30
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回