探索乙型肝炎相关慢加急性肝衰竭免疫调节治疗的新思路  

Immunomodulatory treatment for patients with acute-on-chronic liver failure in chronic hepatitis B

作　　者：张耿林[1] 高志良[1] ZHANG Geng-lin;GAO Zhi-liang(Department of Infectious Diseases,the Third Affiliated Hospital of Sun-Yat-sen University,Guangzhou,Guangdong 510630 ,China)

机构地区：[1]中山大学附属第三医院感染性疾病科,广东广州510630

出　　处：《中国病毒病杂志》2019年第1期1-5,共5页Chinese Journal of Viral Diseases

基　　金：国家"十三五"科技重大专项(2018ZX1030-2204-002)

摘　　要：乙型肝炎(乙肝)相关慢加急性肝衰竭(HBV related acute-on-chronic liver failure,HBV-ACLF)是肝病领域常见的急危重症,发病机制复杂,病情进展迅猛,治疗棘手,预后不佳,是目前研究的热点。人工肝及肝移植治疗存在诸多限制,目前仍以内科综合治疗为主,缺乏特效药物。由于免疫紊乱是其核心的发病机制,因此从免疫调节治疗角度出发,结合时相治疗理念,探索新的治疗策略,将有助于降低患者的病死率。本文将从ACLF的定义差异、发病机制及免疫调节治疗等方面进行综述。Hepatitis B related acute-on-chronic liver failure(HBV-ACLF)is a common and serious disease in China.The pathogenesis is very complex and remains unclear.HBV-ACLF patients usually progress rapidly and lack of effective drugs,resulting in a poor prognosis.There are many limitations in the treatment of artificial liver support and liver transplantation.At present,internal supportive treatment is the main choice.As immune mediated inflammation plays a core role in the pathogenesis of HBV-ACLF,immunomodulatory therapy based on different clinical courses might be a new treatment strategy and help reduce the mortality.In this review,we summarize recent advances in HBV-ACLF,pathogenesis and immunomodulatory therapy.

关 键 词：慢加急性肝衰竭 乙型肝炎病毒 免疫损伤 免疫调节 

分 类 号：R575.3[医药卫生—消化系统]