アブストラクト
| Title | 肝硬変の病態と診断 |
|---|---|
| Subtitle | 今月のテーマ (総説) 新しい肝硬変診療 〜ガイドライン2020を紐解く〜 |
| Authors | 赤羽たけみ, 吉治仁志1) |
| Authors (kana) | |
| Organization | 1)奈良県立医科大学消化器内科学講座 |
| Journal | 日本消化器病学会雑誌 |
| Volume | 118 |
| Number | 1 |
| Page | 14-21 |
| Year/Month | 2021 / 1 |
| Article | 報告 |
| Publisher | 日本消化器病学会 |
| Abstract | 要旨:2015年の肝硬変診療ガイドライン改訂以降, 肝硬変および合併症の病態の解明が進み, 新規治療法が認可されるなど肝硬変診療が大きく変遷した. 肝硬変の病態に腸内細菌叢のdysbiosisや腸管透過性の亢進が深く関連していることや, サルコペニアが予後不良因子であることが明らかにされ, 肝性脳症では潜在性肝性脳症がQOLや予後に影響することが明らかにされつつある. 診断基準や分類では, Acute-on-Chronic Liver Failureの診断基準が作成され, 肝腎症候群の分類は1型・2型からHRS-AKIとnon-AKI-HRSあるいはNAKI-HRSに変更された. 今回の改訂ガイドラインではこれら新たな概念が反映されている. また, ガイドライン改訂作業を通して, いまだに解明されていない点が多く, 今後の検討課題が山積していることも明らかになった. |
| Practice | 臨床医学：内科系 |
| Keywords | 肝硬変, 疫学, 病態, 診断, 合併症 |
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