作　　者： (陆忠华）; (甘建和）;

机构地区： 江南大学附属无锡第五人民医院肝病科,214000

出　　处： 《中华肝脏病杂志》 2017年第9期641-645,共5页

摘　　要： 肝衰竭是由多种因素引起的严重肝脏功能损害，导致其合成、解毒、排泄和生物转化等功能发生严重障碍或失代偿，进而出现以凝血机制障碍、黄疸、肝性脑病、腹水等失代偿为主要表现的一组临床症候群。近年来，随着肝衰竭免疫学发病机制研究深入，“三重打击学说”使得肝衰竭发病机制变得更为清晰。肝衰竭主要的治疗策略包括：阻止肝细胞进一步坏死，促进肝细胞再生，为肝细胞再生创造良好的内环境，积极防治和果断处理各种并发症。掌握肝衰竭患者的免疫状态，选择合适时机早期使用糖皮质激素，可以改善预后，同时减少其不良反应。进一步在不同细胞亚群间建立数量或功能上的平衡及把握某些关键的细胞因子，可能为肝衰竭的免疫调控治疗提供新方向、新靶点。 Liver failure refers to a series of clinical syndromes manifesting as coagulation disorders, jaundice, hepatic encephalopathy, ascites, and other decompensated abnormalities due to serious hepatic dysfunction or decompensation in terms of synthesis, detoxification, excretion, and biological transformation caused by a variety of factors. In recent years, with the development of the research on immunological pathogenesis of liver failure, the ＂three-hit＂ theory clarifies the pathogenesis of liver failure. Major therapeutic strategies for liver failure are to prevent hepatocyte necrosis, promote hepatocyte regeneration, create a good internal environment for hepatocyte regeneration, and actively prevent and treat complications. An understanding of the immtme status of liver failure patients and early application of glucocorticoids at right timing may help to improve prognosis and reduce adverse reactions. Establishment of a quantitative or functional balance between different cell subsets and new thoughts on some key cytokines may provide new directions and targets for immune regulation of liver failure.

关 键 词： 肝功能衰竭 淋巴细胞 调节性 免疫状态 免疫调控治疗