Saner Fuat H, Scarlatescu Ecaterina, Gold Andrew, Abufarhaneh Ehab, Alghamdi Saad Ali, Tolba Yasser, Aljudaibi Bandar, Broering Dieter C, Raptis Dimitri A, Bezinover Dmitri
Hospital & Research Center, Organ Transplant Center of Excellence, Riyadh, Saudi Arabia.
Department of Anesthesia and Intensive Care Medicine III, Fundeni Clinical Institute, Bucharest, Romania; University of Medicine and Pharmacy "Carol Davila", Anesthesia and Intensive Care Department, Bucharest, Romania.
Best Pract Res Clin Gastroenterol. 2024 Dec;73:101962. doi: 10.1016/j.bpg.2024.101962. Epub 2024 Nov 24.
Acute liver failure (ALF) is defined as the loss of hepatic function in conjunction with hepatic encephalopathy and coagulopathy. There is histological evidence of profound hepatocyte damage. If it is not aggressively managed, ALF can be fatal within a few days. It is a rare disease, often occurring in patients without prior liver disease. Despite numerous causes, ALF usually presents as acute liver necrosis with a clinical picture that includes cognitive dysfunction, increased aminotransferases, and severe coagulopathy. It is essential to distinguish between ALF and acute-on-chronic liver failure (ACLF). Causes for ALF include paracetamol Acute liver failure (ALF) is characterized by acute liver dysfunction associated with overdose, right heart failure (ischemic liver injury), viral hepatitis (A, B, D and E), autoimmune hepatitis and drug-induced liver injury (including some herbal and nutritional supplements). In developed countries, the prevalence of ALF is 1:1,000,000. Survival rates have increased due to improved ICU management.
急性肝衰竭（ALF）的定义为肝功能丧失并伴有肝性脑病和凝血功能障碍。存在肝细胞严重受损的组织学证据。如果不积极治疗，急性肝衰竭可能在数天内致命。它是一种罕见疾病，常发生于无既往肝病的患者。尽管病因众多，但急性肝衰竭通常表现为急性肝坏死，临床表现包括认知功能障碍、转氨酶升高和严重凝血功能障碍。区分急性肝衰竭和慢加急性肝衰竭（ACLF）至关重要。急性肝衰竭的病因包括对乙酰氨基酚过量、右心衰竭（缺血性肝损伤）、病毒性肝炎（甲型、乙型、丁型和戊型）、自身免疫性肝炎以及药物性肝损伤（包括一些草药和营养补充剂）。在发达国家，急性肝衰竭的患病率为1:1,000,000。由于重症监护病房（ICU）管理的改善，生存率有所提高。
