Department of Liver and Biliopancreatic Disorders, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, B-3000 Leuven, Belgium.
Crit Care. 2011;15(5):233. doi: 10.1186/cc10424. Epub 2011 Oct 25.
The concept of acute-on-chronic liver failure (ACLF) was introduced recently to describe a subset of patients with chronic liver disease presenting with profound deterioration of liver function and rapidly evolving multi-organ failure. ACLF is frequently accompanied by the development of severe inflammatory response syndrome and has a high mortality. To date, treatment options are limited and exclusively supportive. Over the last few years, some insights have been generated in the pathophysiology of ACLF. A key role for the interaction of innate immune dysfunction, enhanced bacterial translocation from the gut, and circulatory dysfunction has been proposed. In this respect, therapeutic strategies have been examined, with variable success, in experimental studies in animals and humans. This review focuses on potentially relevant pathophysiological elements in the development of ACLF and points out promising treatment modalities in ACLF.
急性肝衰竭（ACLF）的概念是最近提出的，用于描述一组慢性肝病患者，其肝功能严重恶化，多器官功能迅速衰竭。ACLF 常伴有严重炎症反应综合征的发生，死亡率很高。迄今为止，治疗方法有限，仅限于支持性治疗。在过去的几年中，人们对 ACLF 的病理生理学有了一些了解。已经提出了固有免疫功能障碍、肠道细菌易位增强和循环功能障碍相互作用的关键作用。在这方面，在动物和人类的实验研究中，已经检查了各种治疗策略，但取得的成功各不相同。这篇综述重点介绍了 ACLF 发展过程中潜在的相关病理生理因素，并指出了 ACLF 的有前途的治疗方式。
