摘要
肝衰竭是各种肝病发展的严重阶段,病情发展快且危重,病死率高。人工肝不仅可以清除患者体内的有害物质,补充必需物质,为肝细胞再生及肝功能恢复创造机会,而且能延长患者等待肝移植的时间,是肝移植前的桥接。但如今人工肝治疗的广泛开展面临重重困难,如血源紧张、细胞来源困难、疗效不够理想、价格昂贵等,迫切需要创新及改进人工肝治疗方法。近年来发展的新型非生物型人工肝模式,如双重血浆分子吸附系统、分子吸附再循环系统、连续白蛋白净化系统、血浆滤过透析等多种模式的联合应用,在保证疗效的同时节省了血浆用量,减少了副作用。生物型及混合型人工肝具有肝特异性解毒、生物合成及转化功能,有巨大的应用潜能,但细胞来源、细胞培养及生物反应器是其临床应用主要的局限因素。阐述了人工肝在肝衰竭治疗中的现状及应用进展,并为人工肝的发展指出了研究方向。
Liver failure is a serious stage in the development of various liver diseases,with rapid progression,critical conditions,and a high mortality rate. Artificial liver can eliminate toxic substances in the body,supplement essential substances,and create opportunities for hepatocyte regeneration and liver function recovery,and in addition,it can also prolong the waiting time for liver transplantation and thus acts as a bridge to liver transplantation. However,the wide application of artificial liver is facing many difficulties nowadays,such as shortage of blood sources,difficulties in cell sources,a lack of satisfactory effects,and high costs,and therefore,artificial liver treatment needs innovation and improvement. New non-bioartificial liver systems developed in recent years,such as double plasma molecular absorption system,molecular absorbent recirculating system,continuous albumin purification system,and plasma diafiltration,can help to achieve a good clinical outcome and meanwhile reduce the amount of plasma used and minimize side effects. Biological artificial liver and hybrid artificial liver systems have the functions of specific detoxification,biosynthesis,and transformation and thus have great potential in clinical application,which is limited by cell source,cell culture,and bioreactor. This article elaborates on the current status and advances in the application of artificial liver in the treatment of liver failure and provides research directions for the development of artificial liver.
作者
王笑笑
黄建荣
WANG Xiaoxiao;HUANG Jianrong(The First Affiliated Hospital of Zhejiang University School of Medicine,State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,Hangzhou 310003,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2018年第9期1847-1854,共8页
Journal of Clinical Hepatology
基金
国家科技重大专项(2017ZX10203201)
关键词
肝功能衰竭
肝
人工
liver failure
liver
artificial
