Streetz K L, Tacke F, Koch A, Trautwein C
Medizinische Klinik III, Universitätsklinikum RWTH-Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland,
Med Klin Intensivmed Notfmed. 2013 Nov;108(8):639-45. doi: 10.1007/s00063-013-0285-4. Epub 2013 Nov 6.
Although acute liver failure is a rare disease with a prevalence of 5 per 1 million people, it has a considerablely high mortality rate of 34 %. The main causes in western civilizations are drug overdose (acetaminophen) and viral hepatitis. Patients are affected by the loss of liver synthesis function and are at risk of developing hepatic encephalopathy and possible multiorgan failure. Specific therapies consisting of the administration of N-acetylcysteine (acetaminophen) or of nucleotide/nucleoside analogs (hepatitis B) are possible, but are often not adequate. Orthotopic liver transplantation is, therefore, frequently the only remaining effective therapy for severe acute liver failure. Due to organ shortage, new prognostic tools, e.g., the Acute Liver Failure Study Group (ALFSG) score, have been developed to improve patient selection using sufficiently stringent selection criteria.
虽然急性肝衰竭是一种罕见疾病，每100万人中仅有5例，但它的死亡率相当高，达34%。西方文明地区的主要病因是药物过量（对乙酰氨基酚）和病毒性肝炎。患者会因肝脏合成功能丧失而受到影响，并有发生肝性脑病和可能的多器官功能衰竭的风险。可以采用特定疗法，如给予N-乙酰半胱氨酸（用于对乙酰氨基酚中毒）或核苷酸/核苷类似物（用于乙型肝炎），但这些疗法往往并不充分。因此，原位肝移植常常是重症急性肝衰竭唯一剩下的有效疗法。由于器官短缺，人们开发了新的预后工具，如急性肝衰竭研究组（ALFSG）评分，以使用足够严格的选择标准来改善患者选择。
