肝硬化慢加急性肝衰竭的发病诱因及管理

Predisposing factors and management of acute-on-chronic liver failure in cirrhosis

慢加急性肝衰竭(ACLF)是在慢性肝病基础上发生的一种急性失代偿综合征,病情进展迅速,预后不佳,是肝硬化患者死亡的重要原因。诱发因素在ACLF的发生、发展及预后中有重要作用,不同标准下的ACLF对诱因的定义有所差别,地区之间也存在一定异质性。随着医疗卫生事业的发展及生活方式的改变,ACLF诱因的构成也不断发生变化。诱发因素通过多种途径对器官功能造成损伤,导致的器官衰竭种类及预后也存在差异性,早期预警诱发因素可预防ACLF的发生,积极去除诱发因素可改善ACLF的预后,合理管理诱发因素对ACLF患者有积极意义。

Acute-on-chronic liver failure(ACLF) is an acute decompensated syndrome that occurs on the basis of chronic liver disease, with rapid disease progression and poor prognosis, thus being an important cause of death in patients with cirrhosis.Predisposing factors play an important role in the occurrence, progression and prognosis of ACLF, which are heterogeneous in different definitions and regions. With the development of medical and health services and changes in lifestyles, the composition of predisposing factors also changes. These factors cause damage to organ function in various ways, leading to different types of organ failure and prognosis. Early warning of the predisposing factors can prevent the occurrence of ACLF. Actively removing predisposing factors can improve the prognosis of ACLF. Reasonable management of precipitating factors is important for ACLF.