Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.
Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.
复制标题
对乙酰氨基酚引起的肝毒性：全面更新。
DOI：
10.14218/jcth.2015.00052
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发表时间：
2016-06-28
影响因子：
3.6
通讯作者：
Pyrsopoulos N
中科院分区：
文献类型：
--
作者：
Yoon E;Babar A;Choudhary M;Kutner M;Pyrsopoulos N
由于故意和非故意过量使用对乙酰氨基酚（APAP）导致的肝损伤和随后的肝衰竭已经影响患者数十年，并且涉及发生在肝细胞内微粒体中的基础代谢途径。APAP肝毒性仍然是一个全球性问题;特别是在美国，它占超过50%的过量相关急性肝功能衰竭和约20%的肝移植病例。继发于APAP毒性的急性肝功能衰竭的病理生理学、病程和管理仍有待精确阐明，并且伴随发病率和死亡率增加的不良患者结局继续发生。尽管APAP肝毒性遵循可预测的肝衰竭时间轴，但其临床表现可能不同。N-乙酰半胱氨酸（NAC）治疗被认为是主要的治疗方法，但肝移植可能是一个挽救生命的程序，为选定的患者。未来的研究重点在这一领域可能会受益于转向获得解毒剂的知识在分子水平上，重点是潜在的分子信号通路。
Hepatic injury and subsequent hepatic failure due to both intentional and non-intentional overdose of acetaminophen (APAP) has affected patients for decades, and involves the cornerstone metabolic pathways which take place in the microsomes within hepatocytes. APAP hepatotoxicity remains a global issue; in the United States, in particular, it accounts for more than 50% of overdose-related acute liver failure and approximately 20% of the liver transplant cases. The pathophysiology, disease course and management of acute liver failure secondary to APAP toxicity remain to be precisely elucidated, and adverse patient outcomes with increased morbidity and mortality continue to occur. Although APAP hepatotoxicity follows a predictable timeline of hepatic failure, its clinical presentation might vary. N-acetylcysteine (NAC) therapy is considered as the mainstay therapy, but liver transplantation might represent a life-saving procedure for selected patients. Future research focus in this field may benefit from shifting towards obtaining antidotal knowledge at the molecular level, with focus on the underlying molecular signaling pathways.