进展期慢性肝病风险分层与管理措施

摘要/Abstract

摘要： 根据进展期慢性肝病(ACLD)的疾病进展、临床特征及预后差异,学界提出将ACLD的病程划分为代偿期(cACLD)与失代偿期(dACLD)两个阶段。通常而言,cACLD患者5年生存率较高。失代偿事件(如腹水、静脉曲张出血、肝性脑病等)的出现是肝硬化临床病程中的一个重要分水岭,标志着预后急剧恶化,死亡率显著升高。门静脉高压(CSPH)是推动这一转变的核心驱动力,临床上将肝静脉压力梯度(HVPG)≥10 mmHg定义为具有临床意义的CSPH,是失代偿发生的重要阈值。近年来,随着人们对CSPH病理生理机制了解愈加深入,以及非侵入性检测技术(NIT)的发展,阻止cACLD向dACLD进展已成为改善ACLD患者预后的关键环节。本综述围绕基于肝硬化的风险分层、病因及合并症的规范管理,以及CSPH的靶向治疗展开论述,旨在为预防肝硬化失代偿与改善疾病预后提供参考。

关键词: 进展期慢性肝病, 门静脉高压, 非侵入性检测, 风险分层

陈佳, 曹竹君, 谢青. 进展期慢性肝病风险分层与管理措施[J]. 肝脏, 2026, 31(2): 279-283.

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