Abstract:

Acute-on-chronic liver failure (ACLF) is a severe acute liver function decompensation that occurs after an acute attack on the basis of chronic liver disease, which has attracted the attention of hepatologists worldwide due to its rapid progression and sky-high short-term mortality. As the etiology and clinical features of ACLF significantly differ across various countries/regions, there are at least ten diagnostic criteria for ACLF at home and abroad. Therefore, in this paper, we reviewed the studies related to several commonly used definitions and diagnostic criteria of ACLF, and compared the differences among the diagnostic criteria, so as to help clinicians better identify ACLF and optimize clinical decision-making, thereby improving the clinical outcomes of ACLF patients. As there are still no recognized criteria for the diagnosis of ACLF worldwide, and large variations exist between the diagnostic criteria of ACLF at home and abroad, clinicians should select the diagnostic criteria for ACLF with sufficient consideration of etiology of chronic liver disease, clinical characteristics and other factors of patients.

Key words: Acute-on-chronic liver failure, Liver failure, Liver cirrhosis, Hepatitis B, Diagnosis, Review

摘要：

慢加急性肝衰竭（ACLF）是指在慢性肝病基础上遭受急性打击后，出现严重的急性肝功能失代偿，其因病情进展迅速、短期死亡率极高，引起了全球肝病学家的关注。但由于不同国家（地区）ACLF的病因及临床特征等存在明显的差异，目前国内外ACLF的诊断标准多达十余种。本文通过回顾几种较为常用的ACLF定义，以及ACLF诊断标准相关研究，比较各ACLF诊断标准之间的差异，以期帮助临床医生更好地识别ACLF、优化临床决策。目前全球尚无公认的ACLF诊断标准，国内外ACLF的诊断标准存在着较大差异，临床医生在实际工作中选用何种ACLF诊断标准应根据患者慢性肝病的病因、临床特征等因素综合考虑。

关键词: 慢加急性肝功能衰竭, 肝功能衰竭, 肝硬化, 乙型肝炎, 诊断, 综述