肝硬化相关免疫功能障碍的临床意义及研究进展

Clinical significance and research progress in cirrhosis-associated immune dysfunction

肝硬化相关免疫功能障碍(cirrhosis-associated immune dysfunction, CAID)是指肝硬化中存在的广泛的免疫改变。CAID的特点包含全身炎症和免疫缺陷表现出不同的强度, 这取决于肝硬化的阶段和诸如细菌感染等偶发事件的存在。CAID的治疗应包括调节而非抑制免疫反应, 因为消除或刺激炎症反应可能增加感染风险或恶化免疫病理学。本文就肝硬化发生免疫功能障碍的机制及临床意义进行了综述, 阐述了改善肝硬化中功能失调的免疫反应的潜在靶点, 以期为临床上延缓肝硬化进展及挽救肝衰竭提供参考。

Cirrhosis-associated immune dysfunction(CAID)refers to the extensive immune changes present in cirrhosis.The key components of CAID include systemic inflammation and immunodeficiency,which manifest with different intensity depending on the stage of cirrhosis and the presence of contingencies such as bacterial infections.Treatment of CAID should include strategies to modulate rather than suppress the immune response,as eliminating or stimulating the inflammatory response may increase the risk of infection or worsen immunopathology.This review summarizes the mechanisms and clinical implications of immune dysfunction in cirrhosis,and describes potential targets for improving dysfunctional immune responses in cirrhosis,so as to provide reference for clinically delaying the progression of cirrhosis and salvaging liver failure.