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病因治疗在实现失代偿期肝硬化代偿中的作用。

Role of etiological therapy in achieving recompensation of decompensated liver cirrhosis.

作者信息

Garbuzenko Dmitry V

机构信息

Department of Faculty Surgery, South Ural State Medical University, Chelyabinsk 454092, Russia.

出版信息

World J Hepatol. 2025 Apr 27;17(4):105127. doi: 10.4254/wjh.v17.i4.105127.

Abstract

The traditional view of the decompensated stage as a point of no return in the natural history of liver cirrhosis (LC) is currently being questioned. This is due to the appearance of data indicating the possibility of restoring the structure and function of the liver, reducing the portal pressure with a positive effect on complications associated with portal hypertension and decreasing the risk of developing hepatocellular carcinoma after elimination of the etiological factor. To create a unified understanding the recompensation of decompensated LC, at the Baveno VII consensus workshop were developed criteria confirming it. At the moment, the efficacy of etiological therapy in achieving established criteria for recompensation has been evaluated only in patients with alcohol-related, as well as hepatitis B virus-related and hepatitis C virus-related decompensated LC. The purpose of the review is to provide up-to-date information on the role of etiological therapy in achieving recompensation of decompensated LC according to Baveno VII criteria. So far, only the first steps have been taken in studying this problem. To further understand it, research is needed to identify pathophysiological mechanisms, modifying factors, predictors, and potential noninvasive biomarkers of recompensation of decompensated LC.

摘要

肝硬化(LC)自然病程中失代偿期是不可逆转的这一传统观点目前正受到质疑。这是因为有数据表明,肝脏结构和功能有可能恢复,门静脉压力降低,这对门静脉高压相关并发症有积极影响,且在消除病因后肝细胞癌发生风险降低。为了对失代偿期LC的再代偿形成统一认识,巴韦诺VII共识研讨会制定了确认再代偿的标准。目前,仅在酒精性、乙型肝炎病毒相关性和丙型肝炎病毒相关性失代偿期LC患者中评估了病因治疗在达到既定再代偿标准方面的疗效。本综述的目的是提供关于病因治疗在根据巴韦诺VII标准实现失代偿期LC再代偿方面作用的最新信息。到目前为止,在研究这个问题上仅迈出了第一步。为了进一步了解它,需要开展研究以确定失代偿期LC再代偿的病理生理机制、调节因素、预测指标和潜在的非侵入性生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70dd/12038422/a2615907ef33/105127-g001.jpg

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