低收入和中等收入国家的急性肝衰竭
Sandro Vento1, Francesca Cainelli1
1Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia.
The lancet. Gastroenterology & hepatology
|October 14, 2023
概括
急性肝衰竭是一种罕见的,危及生命的疾病. 在低收入国家,病毒性肝炎和热带感染是主要原因,与高收入国家不同.
科学领域:
- 肝病学和传染病的研究
- 全球公共卫生 全球公共卫生
背景情况:
- 急性肝衰竭 (ALF) 是一种快速,严重的肝功能障碍,死亡率高,通常需要移植.
- 现有的关于ALF的数据主要来自高收入国家,其中帕拉西他过量是主要原因.
- 在低收入和中等收入国家 (LMICs) 中对ALF的研究有限.
研究的目的:
- 审查低收入和中等收入国家的急性肝衰竭现有文献.
- 突出这些地区ALF独特的病因概况和临床特征.
- 确定未来研究和干预的关键领域.
主要方法:
- 关于LMIC中急性肝功能衰竭的现有文献的全面审查.
- 发病率,原因,人口统计 (儿童,孕妇),预后因素,治疗和死亡率的分析.
- 结果与高收入国家的数据进行比较.
主要成果:
- 在LMICs中,ALF经常与病毒性肝炎 (特别是E型肝炎),热带感染 (例如登革热),传统药物和抗结核药物有关.
- 在LMIC的患者往往是在初级保健机构管理的.
- 与高收入环境相比,可以观察到不同的预后因素和更高的死亡率.
结论:
- 与高收入国家相比,LMICs中的急性肝衰竭存在独特的病因挑战.
- 迫切需要国际合作,中央注册表,以及在LMICs中改善ALF诊断工具.
- 需要有针对性的公共卫生战略来解决这些地区ALF的具体原因.
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