慢加急性肝衰竭预后评估进展

摘要/Abstract

摘要： 慢加急性肝衰竭(ACLF)是一种在慢性肝病基础上出现的急性肝损伤症候群。乙型肝炎病毒相关慢加急性肝衰竭(HBV-ACLF)是慢性乙型病毒性肝炎(CHB)患者出现肝功能急剧恶化的一种致命性肝病,其短期病死率较高,常伴有器官衰竭。早期及时评估预后有助于提供适当的临床干预,延长患者生存期。尽管目前人工肝支持系统和抗乙型肝炎病毒治疗对早期HBV-ACLF具有一定的疗效,可以显著降低病死率,但是对于晚期HBV-ACLF,需要进行紧急肝移植,否则该疾病短期预后不佳。 ACLF是一个动态过程,最佳预后标志物应随病情严重程度演变。新的预后标志物不仅在遗传学和组织学领域不断发展,而且正朝着与影像学相结合的多样化方向发展。确定哪些患者将从积极的治疗中获益是一项艰巨的挑战,而对 ACLF 进行准确的短期预后评估是解决这一问题的好方法。因此,研究HBV-ACLF预后的预测指标对于疾病的发展具有重要意义。本文综述了HBV-ACLF患者早期及临床结局预测方面的相关实验室指标的研究进展,并对这一领域的未来研究进行展望。

关键词: 慢加急性肝衰竭, 标志物, 预后, 进展

钟良辉, 周定英, 毛雅倩, 钟渊斌. 慢加急性肝衰竭预后评估进展[J]. 肝脏, 2025, 30(1): 128-131.

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