慢加急性肝衰竭合并感染的诊治

Research advances in the diagnosis and treatment of acute-on-chronic liver failure with infection

慢加急性肝衰竭(ACLF)是临床常见的严重肝病症候群,可以导致肝脏合成、代谢、解毒和生物转化等功能的严重障碍和失代偿,并导致多器官功能衰竭和短期内极高的病死率。感染可以诱发或者加重ACLF病情,是患者预后的独立影响因素。简述了ACLF合并感染的机制与特征,归纳了常见的感染类型及临床特征,总结了目前推荐的抗感染方案,提出早期预防性治疗的重要性。ACLF患者合并感染的病情危重,早期诊断和经验性的抗感染治疗是关键。

Acute-on-chronic liver failure(ACLF)is a severe syndrome of liver diseases commonly seen in clinical practice and can lead to severe disorders and decompensation of liver synthesis,metabolism,detoxification,and biotransformation,as well as multiple organ failure and an extremely high short-term mortality rate.Infection can induce or aggravate the condition of ACLF and is an independent influencing factor for patient prognosis.This article describes the mechanism and characteristics of ACLF with infection,summarizes the common types and clinical features of infection,reviews the recommended anti-infective regimens,and emphasizes the importance of early prophylactic treatment.ACLF patients with infection tend to have critical conditions,and early diagnosis and empirical anti-infective treatment is the key to successful treatment.