血清α-fetoprotein动力学在人工肝支持肝功能衰竭中的预后值
Wei-Bo Guo1, Lu-Yao Wang2, Xi-Ju Guo3
1Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China.
World journal of gastroenterology
|September 30, 2025
概括
序列α-fetoprotein (AFP) 监测预测了经过血交换 (PE) 的肝衰竭患者的结果. 较高的基线AFP水平与更好的肝脏再生和改善的生存率相关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 生物标志物发现发现
- 人工肝脏支持系统
背景情况:
- 急性-慢性肝衰竭携带高死亡率.
- 血交换 (PE) 在肝衰竭中显示出可变的疗效,可能与肝脏再生有关.
- 阿尔法-胎蛋白 (AFP) 是肝脏再生的生物标志物,之前的研究表明PE后的预后值.
研究的目的:
- 调查血交换 (PE) 期间的基线α-fetoprotein (AFP) 水平和串行AFP动力学的预测价值,用于肝衰竭患者的临床结果.
- 确定AFP动态是否可以指导风险分层和个性化治疗策略.
主要方法:
- 对经过PE的194名肝衰竭患者的回顾性分析.
- 分层为低 (<100 ng/mL),中 (100-200 ng/mL) 和高 (>200 ng/mL) 的基线AFP组.
- 在PE之前和1,10,20和25日进行了连续的AFP测量.
主要成果:
- 高AFP组需要更少的PE会话,并且与低AFP组相比,显示出更大的PE后AFP升高.
- 高AFP患者表现出更好的肝功能标志物 (较低的氨,胆红素,肝酶;较高的白蛋白,前激素活性) 和减少自发细菌腹膜炎的发生率.
- 高AFP组显示出明显优异的三个月生存率 (90.6%与56.7%) 和更高的预测结果的准确性.
结论:
- AFP动态反映了肝脏的再生能力,并且与PE治疗肝功能衰竭患者的临床结果有很强的相关性.
- 序列AFP监测为增强风险分层和优化肝衰竭管理中的个性化治疗策略提供了有价值的工具.
相关概念视频
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
185
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
185
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
214
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
214
01:14Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
215
In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
215
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
560
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Endoscopic Ultrasound (EUS):
560
01:24Liver Regeneration
4.3K
The liver is an important organ in vertebrates that plays an essential role in metabolism. It is also responsible for storing and redistributing nutrients such as carbohydrates, fats, and vitamins in the body. Additionally, the liver releases bile salts which are critical for digesting food and eliminating toxic metabolites from the body.
Cells of Liver
The liver comprises four major types of cells— hepatocytes, stellate, Kupffer, and sinusoidal endothelial cells. The hepatocytes are...
Cells of Liver
The liver comprises four major types of cells— hepatocytes, stellate, Kupffer, and sinusoidal endothelial cells. The hepatocytes are...
4.3K