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肝衰竭是多种因素引起的肝脏严重损害的一组临床症候群,其病理机制尚未完全阐明.越来越多的研究表明免疫介导的肝脏损伤在肝衰竭的发病过程中起重要作用.慢加急性肝衰竭(ACLF)是肝衰竭最为常见的类型,其发病机制与持续性的炎性反应、免疫过激引起的免疫功能失调、全身炎性反应综合征以及随后的免疫麻痹密切相关.对于ACLF治疗,在传统治疗的基础上给予适当的免疫调节治疗,将有助于延缓或阻止病情进展,改善预后,提高生存率.该文对ACLF的免疫发病机制以及其免疫调节治疗策略进行综述.“,”Liver failure is defined as a clinical syndrome with severe liver injury induced by various etiologies.The pathogenesis of liver failure has not been fully clarified.Increasing evidence suggests that immune-mediated injury plays a pivotal role in the pathogenesis of liver failure.Acute on chronic liver failure (ACLF) is the most common type of liver failure.The pathogenesis of ACLF relates to persistent inflammation,immune dysregulation following initial extensive immune activation,systematic inflammatory response syndrome and subsequent sepsis due to immune paresis.For the treatment of ACLF,appropriate immunomodulatory therapy on the basis of conventional treatment may help to delay or even block the progress of the disease,therefore reduce the mortality and improve the outcome.This paper aimed to summarize the progress in the pathogenesis and the immunomodulatory therapy of ACLF.