摘要
本文对肝衰竭 /重型肝炎的新进展进行综述。在定义上倾向于将急性肝衰竭与慢性肝衰竭及脑病型与非脑病型分开 ;对新近提出的终末期肝病模型 (MELD)预后判断公式进行评价 ;应用拉米夫定 (LAM )治疗伴乙型肝炎病毒 (HBV)复制的肝衰竭有效 ,但肝炎肝硬化患者因不当停药所致肝功能不全患者有所增多 ;LAM加乙型肝炎病毒免疫球蛋白 (HBIg)预防肝移植后HBV感染有效 ,但其逃逸株有增多趋势 ;当前国际上将肝性脑病 (HE)分为三种类型 ,A型为急性肝衰竭相关HE(ALFA HE) ,B型为不伴有内在肝病的门体分流 ,C型指在慢性肝病 /肝硬化基础上发生的HE。
Recent progress on liver failure was reviewed here. Definitionally,the tendency to distinguish acute liver failure from chronic liver failure and encephalopathy from non encephalopathy is more and more obvious. Several researchers evaluated the prognosis judging formula of the model for end stage liver disease(MELD). Lamivudine(LAM) was used to treat patients with liver failure combined HBV replication, but on the other hand, the liver decompensation or liver failure caused by inappropriate termination of lamivudine treatment is increasing. Prophylaxis of HBV reinfection after liver transplantation with lamivudine and hepatitis B immunoglobulin (HBIg) has been verified to be effective, but meanwhile the escape mutants have been increasing. Hepatic encephalopathy are currently divided into three types: type A refers to acute liver failure associated with hepatic encephalopathy(ALFA HE), type B refers to severe portal systemic circulation without preexisting liver disease, and type C refers to hepatic encephalopathy based on chronic liver disease/liver cirrhosis.
出处
《临床内科杂志》
CAS
北大核心
2002年第4期247-250,共4页
Journal of Clinical Internal Medicine
