慢性急性肝衰竭(ACLF)的并发症包括短期死亡率增加。肝外器官衰竭是由慢性肝病和急性肝损伤引起的。这种组合表征终末期肝病。它的快速发展使得肝病学家和重症医师治疗具有挑战性。这种情况的不同定义导致不同的临床表现。肝或肝外衰竭在接受额外损伤的慢性乙型肝炎或肝硬化患者中更为普遍。许多强度参数和预后评级,包括那些乙型肝炎病毒(HBV),已经为各种患者和疾病的原因开发和验证。肝再生,肝移植,或HBV相关ACLF的抗病毒治疗是各种器官衰竭的主要治疗目标。LT是HBV-ACLF的最佳治疗方法。在一些HBV相关的ACLF患者,核苷(t)ide类似物和人工肝辅助可以提高存活率。结合流行病学和临床研究,这篇综述更新了我们对HBV-ACLF定义的理解,诊断,流行病学,病因学,治疗,和预后。
Complications of acute-on-chronic liver failure (ACLF) include increased short-term mortality. Extrahepatic organ failures result from chronic liver disease and acute hepatic injury. This combination characterizes end-stage liver disease. Its rapid progression makes it challenging for hepatologists and intensivists to treat. The varied definitions of this condition lead to varied clinical presentations. Hepatic or extrahepatic failures are more prevalent in chronic hepatitis B or cirrhosis patients who receive an additional injury. Numerous intensity parameters and prognosis ratings, including those for hepatitis B virus (HBV), have been developed and verified for various patients and causes of the disease. Liver regeneration, liver transplantation (LT), or antiviral therapy for HBV-related ACLF are the main treatment aims for various organ failures. LT is the best treatment for HBV-ACLF. In some HBV-related ACLF patients, nucleos(t)ide analogs and artificial liver assistance may enhance survival. Combining epidemiological and clinical studies, this review updates our understanding of HBV-ACLF\'s definition, diagnosis, epidemiology, etiology, therapy, and prognosis.