Dept. Gastroenterology and Hepato-Pancreatology, C.U.B. Erasme Hospital, Brussels, Belgium; Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium; Inserm Unité 1149, Centre de Recherche sur l'inflammation (CRI), Paris, France; UMR S_1149, Université Paris Diderot, Paris, France; The EASL-CLIF Consortium, European Foundation-CLIF, Barcelona, Spain.
The EASL-CLIF Consortium, European Foundation-CLIF, Barcelona, Spain; Liver Failure Group, Insitute for Liver and Digestive Health, University College London, London, UK.
J Hepatol. 2019 Feb;70(2):319-327. doi: 10.1016/j.jhep.2018.12.008.
The spectrum of alcohol-related liver diseases (ALD) includes steatosis, steatohepatitis, progressive liver fibrosis, and cirrhosis. Acute-on-chronic liver failure (ACLF) is a recently defined entity that occurs in patients with chronic liver diseases and is characterised by acute decompensation, organ failures and a high risk of short-term mortality. Active alcohol consumption, alcoholic hepatitis and bacterial infections are the most frequent events precipitating the development of ACLF in the context of ALD (ALD-ACLF). The specific management of this entity remains unknown and the place of salvage liver transplantation controversial. This overview details the current knowledge on specific aspects of epidemiology, pathophysiology, prognosis and management of ALD-ACLF.
酒精性肝病（ALD）的范围包括脂肪变性、脂肪性肝炎、进行性肝纤维化和肝硬化。慢加急性肝衰竭（ACLF）是最近定义的一种实体，发生在慢性肝病患者中，其特征是急性失代偿、器官衰竭和短期死亡率高。在 ALD（ALD-ACLF）的情况下，急性酒精性肝炎和细菌感染是最常见的事件，会导致 ACLF 的发展。这种情况下，该实体的具体治疗方法仍不清楚，挽救性肝移植的地位也存在争议。这篇综述详细介绍了 ALD-ACLF 在流行病学、病理生理学、预后和管理方面的当前知识。
