肝不全の急性と慢性
William Bernal1, Rajiv Jalan2, Alberto Quaglia3
1Liver Intensive Therapy Unit, King's College Hospital, London, UK.
Lancet (London, England)
|October 2, 2015
まとめ
肝臓の重篤な状態である急性慢性肝不全は 高い死亡リスクをもたらします CLIF-Cの臓器不全スコアのような新しい診断ツールがこの複雑な症候群の管理に役立ちます.
科学分野:
- ヘパトロジー
- クリティカル ケア 医療
- 内科 医学
背景:
- 慢性肝疾患の患者の急性肝機能低下を伴う.
- この状態は肝臓と肝臓外臓の機能不全によって特徴付けられ,短期的な死亡率が高い.
- 組織的炎症と感染感受性は,ACLFの主要な病理学的特徴です.
研究 の 目的:
- 慢性肝不全コンソーシアム (CLIF-C) の臓器不全スコアをACLFの分類と予後のために導入する.
- ACLFの高い死亡率のために改善された管理戦略の必要性を強調する.
- ACLFの独特の臨床的および病理学的性質を強調する.
主な方法:
- CLIF-C臓器不全スコアの開発と検証
- 患者のデータを分析して ACLFの特徴と結果を理解する.
- 現行の臨床管理の実践と肝臓移植の介入の検討
主要な成果:
- CLIF-C臓器不全スコアは,ACLFの予後を分類し評価するための新しいツールを提供します.
- 感染やアルコール性肝炎は一般的な原因ですが, 40%以上の症例には特定されたトリガーはありません.
- 肝臓移植は 特定のケースでは有効ですが 臓器の入手やタイミングなどの障害に直面します
結論:
- ACLFは特定の診断および予後基準を必要とする独特の症候群です.
- 効果的な治療には 沈殿物を処理し サポートケアを提供し 肝臓移植を考える必要があります
- ACLFの死亡率を減らすために管理経路と介入のさらなる開発が不可欠です.
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