肝衰竭预后相关标志物的应用现状与展望

刘叶莹; 王婷; 窦爱华; 郑素军; 徐斌; 刘梅

doi:10.3969/j.issn.1001-5256.2019.05.046

肝衰竭预后相关标志物的应用现状与展望

DOI: 10.3969/j.issn.1001-5256.2019.05.046

首都医科大学附属北京佑安医院疑难肝病及人工肝中心

基金项目:

北京市医院管理局临床医学发展专项经费资助(XMLX201830)；北京卫生系统高技术人才培养项目基金(2015-3-104)；北京市教委科技计划面上项目(KM201610025021)；国家135科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”(2017ZX10202203-006,2017ZX10302201-004,2018ZX10301407-005,2018ZX10302205-004)；

详细信息

中图分类号: R575.3
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出版历程
- 收稿日期: 2018-11-05
- 出版日期: 2019-05-20

Current status and perspectives of prognostic markers for liver failure

Intractable Hepatic Diseases and Artificial Liver Treatment & Training Center, Beijing YouAn Hospital, Capital Medical University

Research funding:

摘要

摘要: 准确判断病情和预后对于提高肝衰竭患者的生存率和最优分配肝源具有重要意义。阐述了目前临床常用的预测肝衰竭预后相关标志物如ALT、AST、TBil、PT、PTA、国际标准化比值等应用现状,归纳了近年来新发现的相关标志物如炎性反应相关标志物、中性粒细胞明胶酶相关脂质运载蛋白、免疫反应相关标志物、角蛋白、肠道菌群、微小RNA、肝衰竭自身抗原抗体以及血液动力学紊乱等方面的研究进展,提出肝衰竭预后受多种因素影响,目前仍缺乏更敏感有效的标志物以及规范的预后评分系统。将新发现的标志物单独或与其他传统标志物联合应用,或将有助于提升肝衰竭预后判断的敏感性和特异性。
- 肝功能衰竭 /
- 预后 /
- 生物学标记 /
- 综述
Abstract: Accurate judgment of conditions and prognosis has important clinical significance in improving survival rate and optimal distribution of liver source in patients with liver failure. This article reviews the current application of prognostic markers for liver failure such as alanine aminotransferase, aspartate aminotransferase, total bilirubin, prothrombin time, prothrombin time activity, and international normalized ratio and summarizes the new markers discovered in recent years, such as inflammatory response-related markers, neutrophil gelatinase-associated lipocalin, immune response-related markers, keratin, intestinal flora, microRNAs, liver failure autoantigen and autoantibody, and hemodynamic disorder. It is pointed out that the prognosis of liver failure is affected by many factors and there is still a lack of more sensitive and effective markers and a standardized prognostic scoring system. The new markers used alone or in combination with traditional markers may help to improve the sensitivity and specificity of prognostic evaluation of liver failure.
- liver failure /
- prognosis /
- biological markers /
- review

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参考文献(38)

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