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首页> 外文期刊>Current opinion in gastroenterology >Acute on chronic liver failure: definitions, treatments and outcomes
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Acute on chronic liver failure: definitions, treatments and outcomes

机译：急性慢性肝衰竭：定义，治疗方法和结果

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Purpose of reviewAcute on chronic liver failure (ACLF) causes significant morbidity and mortality in patients with cirrhosis and/or chronic liver disease (CLD). The purpose of this review is to highlight recent studies that have better defined ACLF, and to highlight current outcomes and treatment strategies.Recent findingsCurrently, there are no clear definitions for ACLF; however, ACLF requires a precipitating event that occurs in the setting of cirrhosis and/or CLD, and progresses rapidly to multiorgan failure with high mortality. Most precipitants of ACLF are due to infections, leading to inflammatory cascades, hence early treatment with antibiotics in these cases might show benefit. Prognosis in ACLF typically depends on the number of extrahepatic organs affected. Potential biomarkers in ACLF may result in early detection and risk stratification; however, further research is needed. ACLF portends a poor prognosis; however, rescue therapy with liver transplantation has been considered in selected cases.SummaryACLF is a common and devastating complication of cirrhosis or CLD. ACLF usually requires a precipitating event and rapid progression to multiorgan failure with high mortality. Although signs and symptoms might overlap in patients with ACLF and those with decompensated cirrhosis, the two entities should be distinguished separately (although it is challenging to differentiate these in certain cases). Furthermore, diagnosing each entity should be based on a variety of clinical indicators, laboratory data and precipitating factors, in order to determine the best possible targeted treatment strategies. Refinement in the clinical definitions for ACLF may lead to better management and possibly better outcomes if recognized early.
机译：审查目的慢性肝功能衰竭（ACLF）急性导致肝硬化和/或慢性肝病（CLD）患者的高发病率和死亡率。这篇综述的目的是强调最近对ACLF进行更好定义的研究，并强调当前的结果和治疗策略。但是，ACLF需要在肝硬化和/或CLD的环境中发生沉淀事件，并迅速发展为多器官衰竭，死亡率很高。 ACLF的大多数沉淀物是由于感染导致的炎症级联反应，因此在这些情况下早期应用抗生素治疗可能会显示出益处。 ACLF的预后通常取决于受影响的肝外器官的数量。 ACLF中潜在的生物标志物可能导致早期发现和风险分层;但是，还需要进一步的研究。 ACLF预后不良。然而，在某些情况下，已经考虑采用肝移植进行抢救治疗。SummaryACLF是肝硬化或CLD的常见且具有破坏性的并发症。 ACLF通常需要发生沉淀事件并迅速发展为多器官功能衰竭，死亡率高。尽管ACLF和失代偿性肝硬化患者的体征和症状可能重叠，但是应分别区分这两个实体（尽管在某些情况下要区分这两个实体具有挑战性）。此外，诊断每个实体应基于各种临床指标，实验室数据和诱发因素，以便确定最佳的可能的靶向治疗策略。尽早发现ACLF临床定义的细化可能会导致更好的治疗，甚至可能带来更好的结果。

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