乙型肝炎相关慢加急性肝衰竭免疫损伤机制研究进展

Progress in immunologic injury mechanism of hepatitis B virus-related acute-on-chronic liver failure

乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)定义为在乙型肝炎病毒(HBV)引起的慢性肝病(包括肝硬化和非肝硬化)基础上,表现为肝功能急性失代偿合并肝脏或肝外器官衰竭的一组具有短期高病死率的临床综合征。该病以短期高病死率和显著的全身炎症反应为特征,其发病是一个动态变化的复杂过程,目前机制并不明确,“三重打击”是较为公认的学说,免疫损伤在其中发挥重要作用,本文将重点阐述HBV-ACLF患者免疫炎症损伤相关研究进展。

Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)is identified as a complicated syndrome with a high short-term mortality rate that develops in patients with HBV-related chronic liver disease regardless of the presence of cirrhosis.Meanwhile,HBV-ACLF is characterized by acute deterioration of liver function and hepatic and/or extrahepatic organ failure.This disease is associated with systemic inflammatory response,but the exact mechanism remains unclear.The hypothesis of"triple attack"is a relatively recognized theory for the development of HBV-ACLF,in which host immunity plays an important role.This review will focus on the current development of innate and adaptive immune responses in patients with HBV-ACLF.