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中华移植杂志(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 268 -271. doi: 10.3877/cma.j.issn.1674-3903.2020.04.017

所属专题: 文献

综述

药物性急性肝衰竭行肝移植治疗的预后因素探讨
丁超峰1, 高晟2, 郑树森3,()   
  1. 1. 310003 杭州,浙江大学医学院附属第一医院肝胆胰外科
    2. 卫健委多器官联合移植研究重点实验室
    3. 310003 杭州,浙江大学医学院附属第一医院肝胆胰外科;卫健委多器官联合移植研究重点实验室
  • 收稿日期:2020-01-06 出版日期:2020-08-25
  • 通信作者: 郑树森

Prognostic factors of liver transplantation for patients with drug induced acute liver failure

Chaofeng Ding1, Sheng Gao2, Shusen Zheng3,()   

  1. 1. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
    2. NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China
    3. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310003, China
  • Received:2020-01-06 Published:2020-08-25
  • Corresponding author: Shusen Zheng
  • About author:
    Corresponding author: Zheng Shusen, Email:
引用本文:

丁超峰, 高晟, 郑树森. 药物性急性肝衰竭行肝移植治疗的预后因素探讨[J/OL]. 中华移植杂志(电子版), 2020, 14(04): 268-271.

Chaofeng Ding, Sheng Gao, Shusen Zheng. Prognostic factors of liver transplantation for patients with drug induced acute liver failure[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2020, 14(04): 268-271.

药物性肝损伤致急性肝衰竭是一种既少见又非常严重的肝细胞损伤疾病,常导致转氨酶快速升高、肝性脑病发生及凝血功能紊乱等,危及患者生命。药物性肝损伤致急性肝衰竭的病因主要分为固有型药物性损伤(主要为对乙酰氨基酚类药物毒性)和特异质型药物性损伤(含中药、保健药品所致的药物性肝损伤)。随着综合救治措施的完善,虽然固有型药物性急性肝衰竭患者起病急骤,但超过75%能自愈。然而,特异质型药物性急性肝衰竭患者,往往发病缓慢,病程长,约60%需要肝移植来挽救生命。建立基于病因及临床多参数的预测模型,有助于识别药物性急性肝衰竭的自然病程,及时制订肝移植为核心的治疗策略,显著改善预后。

Acute liver failure (ALF) secondary to drug induced liver injury (DILI) is a rare and severe consequence of hepatocyte injury, which leads to a rapid-onset elevation of aminotransferases, hepatic encephalopathy, coagulopathy and so on. The main causes of DILI related-ALF can be classified to acetaminophen(APAP)-related ALF (mainly for acetaminophen) and idiosyncratic DILI (herbal and dietary supplements and so on). APAP-related ALF presents with a hyperacute liver injury and more than 75% of patients can survive without liver transplantation, while idiosyncratic DILI-related ALF develops more slowly, approximately 60% of patients require liver transplantation. Establishment of a prediction model based on the causes and clinical parameters, will help to recognize the nature history of DILI-related ALF and work out timely treatment strategies focusing on liver transplantation, finally to improve the overall survival.

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