急性肝衰竭血浆置换治疗生存获益的争议与思考

杨笛; 金清龙

doi:10.12449/JCH250708

急性肝衰竭血浆置换治疗生存获益的争议与思考

DOI: 10.12449/JCH250708

杨笛,
金清龙^, ,

吉林大学第一医院肝胆胰内科，长春 130000

基金项目:

国家自然科学基金 (82170535)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：杨笛负责撰写论文；金清龙负责拟定写作思路，指导论文撰写并修改论文。

详细信息

通信作者:
金清龙， jinql@jlu.edu.cn （ORCID： 0000-0002-4626-9828）

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- 被引次数: 0
出版历程
- 收稿日期: 2025-06-04
- 录用日期: 2025-06-26
- 出版日期: 2025-07-25

The survival benefit of plasma exchange in patients with acute liver failure： Controversies and thoughts

Di YANG,
Qinglong JIN^{,
,}

Department of Hepatology，The First Hospital of Jilin University，Changchun 130000，China

Research funding:

National Natural Science Foundation of China (82170535)

More Information

Corresponding author: JIN Qinglong， jinql@jlu.edu.cn （ORCID： 0000-0002-4626-9828）

摘要

摘要: 急性肝衰竭（ALF）是一种罕见但病情凶险的临床综合征，当前治疗以支持治疗和肝移植为主。血浆置换（PEX）作为一种血液净化技术，可清除炎症介质和毒素，是临床广泛应用的肝移植替代治疗方案，已被证实可减轻ALF炎症反应，稳定血流动力学，提高患者生存率。然而，2025年4月在Journal of Hepatology发表的一项英国多中心、回顾性队列研究显示，ALF患者经PEX治疗后，总体生存获益或无移植生存率未见改善，引发学界广泛争论。本文总结了PEX治疗在ALF中的应用进展，并对相关争议问题进行了探讨。
- 肝功能衰竭，急性 /
- 血浆置换 /
- 多器官功能衰竭 /
- 肝移植
Abstract: Acute liver failure （ALF） is a rare but life-threatening clinical syndrome， and supportive care and liver transplantation are currently the main treatment methods for ALF. Plasma exchange （PEX）， as a blood purification technique， can remove inflammatory mediators and toxins， and it is a widely used alternative therapy for liver transplantation in clinical practice. Studies have shown that PEX can alleviate inflammatory response， stabilize hemodynamics， and improve survival rate in ALF patients. However， a multicenter retrospective cohort study in the UK published in Journal of Hepatology in April 2025 showed that there was no improvement in overall survival benefit or transplantation-free survival rate in ALF patients after PEX， which has led to widespread debate in the academic world. This article reviews the advances in the application of PEX in ALF and discusses related controversial issues.
- Liver Failure， Acute /
- Plasma Exchange /
- Multiple Organ Failure /
- Liver Transplantation

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参考文献(29)

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