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肝硬化:免疫功能低下状态。

Liver Cirrhosis: The Immunocompromised State.

作者信息

Rodríguez-Negrete Elda Victoria, Gálvez-Martínez Marisol, Sánchez-Reyes Karina, Fajardo-Felix Carlos Fernando, Pérez-Reséndiz Karla Erika, Madrigal-Santillán Eduardo Osiris, Morales-González Ángel, Morales-González José Antonio

机构信息

Servicio de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Ciudad de México 06720, Mexico.

Laboratorio de Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico.

出版信息

J Clin Med. 2024 Sep 20;13(18):5582. doi: 10.3390/jcm13185582.

Abstract

Systemic inflammation and immunodeficiency are important components of cirrhosis-associated immune dysfunction (CAID), the severity of which is dynamic, progressive, and associated with the greater deterioration of liver function. Two inflammation phenotypes have been described: low-grade and high-grade systemic inflammation. Both of these phenotypes are related to liver cirrhosis function; thus, high-grade inflammation is correlated with the severity of hepatic insufficiency, bacterial translocation, and organic insufficiency, with which the risk of infections increases and the prognosis worsens. Bacterial translocation (BT) plays a relevant role in persistent systemic inflammation in patients with cirrhosis, and the prophylactic employment of antibiotics is useful for reducing events of infection and mortality.

摘要

全身炎症和免疫缺陷是肝硬化相关免疫功能障碍(CAID)的重要组成部分,其严重程度是动态的、渐进性的,并且与肝功能的进一步恶化相关。已描述了两种炎症表型:低度和高度全身炎症。这两种表型均与肝硬化功能有关;因此,高度炎症与肝功能不全、细菌移位和器官功能不全的严重程度相关,感染风险增加且预后恶化。细菌移位(BT)在肝硬化患者持续性全身炎症中起相关作用,预防性使用抗生素有助于减少感染事件和死亡率。

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