Kazuto Tajiri, Third Department of Internal Medicine, Toyama University Hospital, Toyama 930-0194, Japan.
World J Gastroenterol. 2013 Dec 14;19(46):8459-67. doi: 10.3748/wjg.v19.i46.8459.
The liver experiences various changes with aging that could affect clinical characteristics and outcomes in patients with liver diseases. Both liver volume and blood flow decrease significantly with age. These changes and decreased cytochrome P450 activity can affect drug metabolism, increasing susceptibility to drug-induced liver injury. Immune responses against pathogens or neoplastic cells are lower in the elderly, although these individuals may be predisposed to autoimmunity through impairment of dendritic cell maturation and reduction of regulatory T cells. These changes in immune functions could alter the pathogenesis of viral hepatitis and autoimmune liver diseases, as well as the development of hepatocellular carcinoma. Moreover, elderly patients have significantly decreased reserve functions of various organs, reducing their tolerability to treatments for liver diseases. Collectively, aged patients show various changes of the liver and other organs that could affect the clinical characteristics and management of liver diseases in these patients.
肝脏随着年龄的增长会经历各种变化，这些变化可能会影响肝病患者的临床特征和结局。肝体积和血流量都会随着年龄的增长而显著下降。这些变化以及细胞色素 P450 活性的降低会影响药物代谢，增加药物性肝损伤的易感性。老年人对病原体或肿瘤细胞的免疫反应较低，尽管这些个体可能由于树突状细胞成熟受损和调节性 T 细胞减少而容易发生自身免疫。这些免疫功能的变化可能会改变病毒性肝炎和自身免疫性肝病的发病机制，以及肝细胞癌的发展。此外，老年患者的各种器官储备功能明显下降，降低了他们对肝病治疗的耐受性。总的来说，老年患者的肝脏和其他器官会发生各种变化，这可能会影响这些患者的肝病临床特征和管理。
