慢加急性肝衰竭临床评分及分型系统的演变进程

Evolution of the clinical scoring and classification system for acute-on-chronic liver failure

慢加急性肝衰竭(ACLF)发病机制复杂,临床治疗困难,预后差。由于不同国家地区慢性肝病分布的不同,在过去的几十年中,有超过十种ACLF评分及分型标准被提出,表明ACLF在定义、评分及分型方面存在较大分歧。通过梳理具有广泛影响的几种评分及分型的特点,探讨其演变进程及适用于我国的分型标准,为优化治疗方案提供参考。

Acute-on-chronic liver failure(ACLF)has complex pathogeneses,difficulties in clinical treatment,and poor prognosis.Due to the differences in the distribution of chronic liver diseases in different countries and regions,more than ten scoring and classification systems for ACLF have been proposed in the past few decades,indicating that there are great differences in the definition,scoring,and classification of ACLF.By analyzing the characteristics of several widely used scoring and classification systems,this article discusses their evolution process and the classification criteria applicable to China,so as to provide a reference for optimizing treatment regimens.