肝硬化
失代偿
医学
腹水
器官功能障碍
门脉高压
肝性脑病
重症监护医学
内科学
败血症
作者
Rajiv Jalan,Gennaro D’Amico,Jonel Trebicka,Richard Moreau,Paolo Angeli,Vicente Arroyo
标识
DOI:10.1016/j.jhep.2021.01.018
摘要
Traditionally, the complications of cirrhosis, namely variceal bleeding, ascites and hepatic encephalopathy, were thought to result predominantly from circulatory dysfunction and altered organ perfusion arising as a result of portal hypertension. Over the past 20 years, large, international prospective studies have indicated the importance of systemic inflammation and organ immunopathology as additional determinants of organ dysfunction in cirrhosis, which not only manifests in the liver, brain, circulation and the kidneys, but also the immune system, gut, muscles, adrenal glands, reproductive organs, heart and lungs. This review provides an overview of the traditional and emerging concepts around the initiation and maintenance of organ dysfunction in cirrhosis and proposes a new paradigm based upon a better understanding of acute decompensation of cirrhosis. The interaction between the traditional concepts and the emerging perspectives remains a matter of great interest and the basis for future research.
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