慢加急性肝衰竭病人免疫功能障碍的机制研究进展

Research progress in the mechanism of immune dysfunction in patients with acute-on-chronic liver failure

慢加急性肝衰竭(ACLF)是临床常见的危重肝病综合征,病情进展迅速,预后差,病死率极高。虽然东西方关于ACLF存在定义上差异,但在发病机制上,均认为炎症反应和免疫功能障碍在病程进展中发挥关键作用。ACLF病人常伴有免疫功能障碍,增加了继发感染和感染相关死亡的风险,同时也是其他并发症发生的重要诱因,如肝性脑病、肝肾综合征、腹水、低钠血症、感染性休克等。因此,深入了解肝衰竭病人免疫功能障碍的发生发展机制,可为ACLF防治提供新的理论基础和依据。该研究对先天免疫和获得性免疫中各类细胞的数量、功能及分泌等方面的功能障碍作一综述。

Acute-on-chronic liver failure(ACLF)is a common clinical critical liver disease syndrome with rapid progression,poor prognosis and high mortality.Although there is difference in the definition of ACLF between the East and the West,there are similarities in pathogenesis,and inflammatory response and immune dysfunction play a key role in the progression of the disease.ACLF patients are often accompanied by immune dysfunction,which increases the risk of secondary infection and infection-related death,and is also an important cause of other complications,such as hepatic encephalopathy,hepatorenal syndrome,ascites,hyponatremia,septic shock,etc.Therefore,in-depth understanding of the occurrence and development mechanism of immune dysfunction in patients with liver failure can provide a new theoretical basis for the prevention and treatment of ACLF.This paper reviews the number,function and secretion dysfunction of various cells in innate and acquired immunity.