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Acetaminophen hepatotoxicity: an updated review

机译:对乙酰氨基酚肝毒性:最新评论

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As the most common cause of acute liver failure (ALF) in the USA and UK, acetaminophen-induced hepatotoxicity remains a significant public health concern and common indication for emergent liver transplantation. This problem is largely attributable to acetaminophen combination products frequently prescribed by physicians and other healthcare professionals, with unintentional and chronic overdose accounting for over 50 % of cases of acetaminophen-related ALF. Treatment with N-acetylcysteine can effectively reduce progression to ALF if given early after an acute overdose; however, liver transplantation is the only routinely used life-saving therapy once ALF has developed. With the rapid course of acetaminophen-related ALF and limited supply of donor livers, early and accurate diagnosis of patients that will require transplantation for survival is crucial. Efforts in developing novel treatments for acetaminophen-induced ALF are directed toward bridging patients to recovery. These include auxiliary, artificial, and bioartificial support systems. This review outlines the most recent developments in diagnosis and management of acetaminophen-induced ALF.
机译:作为美国和英国急性肝衰竭(ALF)的最常见原因,对乙酰氨基酚引起的肝毒性仍然是重要的公共卫生问题,也是紧急肝移植的普遍指征。该问题主要归因于医师和其他医疗保健专业人员经常开具的对乙酰氨基酚联合产品,无意和长期过量服用对乙酰氨基酚相关的ALF病例超过50%。如果在急性用药过量后早期给予N-乙酰半胱氨酸治疗,可有效减少ALF的进展。但是,一旦ALF出现,肝移植是唯一常规使用的挽救生命的疗法。随着对乙酰氨基酚相关ALF病程的迅速发展以及供体肝脏的供应有限,早期和准确诊断需要移植才能生存的患者至关重要。开发对乙酰氨基酚诱导的ALF的新型治疗方法的努力旨在使患者恢复健康。这些包括辅助,人工和生物人工支持系统。这篇综述概述了对乙酰氨基酚诱导的ALF的诊断和管理的最新进展。

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