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求同存异，兼容并济——从国内外慢加急性肝衰竭定义的演变历程统一共识
DOI: 10.12449/JCH241108
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：徐曼曼负责撰写论文；陈煜负责拟定写作思路，指导论文撰写并修改论文。
Unified consensus and evolution of the definition of acute-on-chronic liver failure： Seeking common ground while reserving differences
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摘要: 在慢加急性肝衰竭（ACLF）这一概念被提出的近30年来，随着对其发病机制、诊断标准、治疗措施等各个方面研究的不断深入，来自全球范围内的相关诊疗共识指南也在不断更新，但ACLF的定义始终未得到统一，定义的不同必然会阻碍诸多治疗手段、预后评分、诊疗意见的推广应用。近年来，肝病学专家们不断提出了统一ACLF定义的方式方法，求同存异，取长补短，最终力求使ACLF的定义趋于一致。Abstract: The concept of acute-on-chronic liver failure （ACLF） has been introduced for nearly 30 years， and with extensive research on its pathogenesis， diagnostic criteria， and treatment strategies， related consensus statements and guidelines have been constantly updated in China and globally； however， there is still a lack of a unified definition of ACLF， and such differences in definition may inevitably hinder the application and implementation of various treatment methods， prognostic scoring systems， and clinical recommendations. In recent years， hepatology experts have continuously proposed methods to unify the definition of ACLF， seeking common ground while reserving differences and drawing on the strengths of various definitions， in order to achieve a more unified definition of ACLF.
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Key words:
- Acute-on-Chronic Liver Failure /
- Definition /
- Evolution
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注： APASL，亚太肝病学会；CMA，中华医学会；COSSH，中国重型乙型肝炎研究小组；EASL，欧洲肝病学会；NACSELD，北美终末期肝病学会。
图 1 世界各地肝病学会发布ACLF指南或共识时间轴
Figure 1. Liver societies around the world publish ACLF guidelines or consensus timelines
注： ACG，美国胃肠病学院；AASLD，美国肝病学会；WGO，世界胃肠病学组织；CGSLD，中国重症肝病小组。
图 2 为统一ACLF定义，世界各地学会及学者的建议
Figure 2. Recommendations from scholars and societies around the world to unify the definition of ACLF
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