Sussman N L, Kelly J H
Baylor College of Medicine, Amphioxus Inc., Houston, Tex., USA.
Clin Invest Med. 1996 Oct;19(5):393-9.
Without adequate liver function, the body is unable to sustain several vital metabolic functions, such as energy supply, acid-base balance and thermoregulation. Whereas the clinical picture of chronic liver failure is often dominated by portal hypertension, fulminant hepatic failure (FHF) is typically characterized by an acute metabolic deficit. Another important distinction between these two conditions is that the liver can recover from an acute injury such as FHF. Hepatocytes retain the ability to divide in vivo; therefore, recovery from FHF is possible, although rare, if the liver can regenerate before the patient succumbs to the disease. This review examines the theoretical and practical aspects of metabolic liver support, with FHF as the paradigm.
若没有足够的肝功能,身体便无法维持多项重要的代谢功能,如能量供应、酸碱平衡及体温调节。慢性肝功能衰竭的临床表现通常以门静脉高压为主,而暴发性肝衰竭(FHF)的典型特征则是急性代谢缺陷。这两种病症的另一个重要区别在于,肝脏能够从诸如FHF这样的急性损伤中恢复。肝细胞在体内保留了分裂能力;因此,尽管罕见,但如果肝脏能在患者死于该疾病之前再生,FHF就有可能恢复。本综述以FHF为范例,探讨代谢性肝支持的理论和实践方面。