Department of Haematology, Beaumont Hospital, Dublin, Ireland.
Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J Thromb Haemost. 2023 Nov;21(11):3045-3055. doi: 10.1016/j.jtha.2023.06.017. Epub 2023 Jun 21.
Our understanding of the function of the liver has evolved over the centuries. Early theories proposing that the liver could be used to divine the future have been superseded by our current knowledge of the importance of the liver in processes such as digestion and detoxification. Similarly, although liver disease was previously associated with only an increased risk of bleeding, there is now a substantial body of evidence demonstrating an increased thrombotic potential in patients with this disease. Metabolic-associated fatty liver disease (MAFLD) is increasing in frequency and is likely to overtake alcoholic liver disease as the primary indication for liver transplant in the future. In this review, we discuss the evidence linking liver disease, and MAFLD in particular, with arterial and venous thromboembolic disease. We review the safety and efficacy of anticoagulation in advanced liver disease and consider whether antithrombotic agents could slow or halt the progression of fibrosis in MAFLD.
几个世纪以来，我们对肝脏功能的理解一直在不断发展。早期提出的肝脏可以用于占卜未来的理论已经被我们目前对肝脏在消化和解毒等过程中的重要性的认识所取代。同样，尽管以前肝脏疾病仅与出血风险增加相关，但现在有大量证据表明，患有这种疾病的患者的血栓形成潜力增加。代谢相关性脂肪性肝病 (MAFLD) 的发病率正在增加，并且很可能在未来超过酒精性肝病成为肝移植的主要指征。在这篇综述中，我们讨论了将肝病，特别是 MAFLD 与动脉和静脉血栓栓塞性疾病联系起来的证据。我们回顾了在晚期肝病中抗凝治疗的安全性和有效性，并考虑了抗血栓药物是否可以减缓或阻止 MAFLD 中的纤维化进展。
