慢加急性肝衰竭诊断标准东西方差异再认识

Differences in the diagnostic criteria for acute-on-chronic liver failure between the East and the West

慢加急性肝衰竭(ACLF)是危及全球公共健康的重大疾病,内科综合治疗病死率高达50%~90%,早期诊断和治疗对降低ACLF病死率至关重要。由于东西方国家ACLF主要病因不同,至今仍无统一的ACLF定义与诊断标准,有无肝硬化疾病基础是ACLF诊断标准的争议焦点。综述了近年来有关ACLF定义与诊断标准、诱因及发病机制的最新研究结果,为制订新的治疗策略和国际指南提供理论依据。

Acute-on-chronic liver failure( ACLF) is a serious threat to global public health,with a mortality rate of as high as 50%-90% after comprehensive medical treatment,and early diagnosis and treatment are of vital importance to reducing the mortality rate of ACLF.Due to the difference in major etiologies of ACLF between the East and the West,there are still no universally accepted diagnostic criteria for ACLF,with controversies over whether the underlying disease of liver cirrhosis should be one of the diagnostic criteria for ACLF.This article reviews the latest research advances in the definition,diagnostic criteria,predisposing factors,and pathogenesis of ACLF,in order to provide a theoretical basis for the development of new treatment strategies and international guidelines.