肝硬化患者复代偿的临床研究进展

摘要/Abstract

摘要： 肝硬化的自然进程一般分为代偿期和失代偿期。虽然传统上认为肝硬化从代偿期发展到失代偿期是单向且不可逆的病程,但近期研究揭示,在有效治疗肝硬化潜在病因后,部分患者可能经历炎症减轻、纤维化消退,不再出现失代偿事件,最终实现肝脏功能的复代偿(再代偿)和疾病逆转。Baveno VII共识为肝硬化复代偿提供了明确的定义标准,包括消除主要病因、不再发生失代偿事件以及肝功能持续改善。肝硬化的复代偿涉及多方面的病理生理学变化,如降低门脉压力、减少肝纤维化、改善肠道通透性及改善代谢等。随着针对特定病因治疗的研究进展,肝硬化复代偿的重要性逐渐增加。目前,关于肝硬化复代偿的研究尚处于起步阶段,Baveno VII共识基于专家建议对肝硬化复代偿的概念进行了界定,但对于肝功能改善标准、病情动态变化、预后分层等方面的细节仍存在不明确之处。因此,在诊断和管理肝硬化复代偿时,临床医师需要特别谨慎,尤其是考虑到相关的伦理问题和长期结果的不确定性。

邓优, 王琦, 赵红, 谢雯. 肝硬化患者复代偿的临床研究进展[J]. 肝脏, 2024, 29(1): 9-12.

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