急性肝不全:症候群の再定義
J G O'Grady1, S W Schalm, R Williams
1Institute of Liver Studies, King's College School of Medicine and Dentistry, London, UK.
Lancet (London, England)
|July 31, 1993
まとめ
急性肝不全 (ALF) の新しい用語は,黄から脳性病のタイミングに基づいて,超急性,急性,および亜急性形態を区別します. この分類は,臨床的特徴,予後に関する理解を向上させ,よりよい患者管理のための臨床試験の標準化に役立つ.
科学分野:
- 肝臓病理学 肝臓病理学
- クリニカル・メディシン 臨床医学
- 医学用語集 医学用語集
背景:
- 急性肝不全 (ALF) の現在の定義は,臨床表現と患者のアウトカムの変動を十分に捉えていません.
- ALF患者の臨床的特徴と予後には大きな違いがあります.
研究 の 目的:
- 急性肝不全症候群を分類するための新しい,洗練された用語を提案する.
- ALF分類における臨床的特徴と予後を正確に反映することを改善する.
- ALF患者の管理を支援し,臨床試験を標準化する.
主な方法:
- ロンドンのキングズ・カレッジ病院 (1972年−1985年) で治療されたALF患者の大群の分析.
- 黄の発症と脳性病の発症の間の間隔に基づいて分類する.
主要な成果:
- 急性肝不全:黄発症から7日以内に脳梗塞;脳腫にもかかわらず,医療による治療で高い生存率.
- 急性肝不全:黄の8~28日後の脳病変;高い脳腫の発生率,移植なしでは予後が悪い.
- 亜急性肝不全:黄後5~12週間の脳病変;脳腫の発生率が低く,予後が悪い.
結論:
- 提案された用語 (過急性,急性,亜急性肝不全) は,ALF内の異なる臨床症候群をより良く定義します.
- この分類は,患者の管理に役立ち,治療試験のための標準化された枠組みを提供します.
- 正確な分類は,急性肝不全の予後を理解し,治療決定を導くために重要である.
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