Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and Acute Liver Failure
Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and Acute Liver Failure
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DOI：
10.1016/j.cld.2018.01.007
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发表时间：
2018-05-01
影响因子：
5.1
通讯作者：
Reddy, K. Rajender
中科院分区：
文献类型：
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作者：
Bunchorntavakul, Chalermrat;Reddy, K. Rajender
对乙酰氨基酚（APAP）是急性肝功能衰竭（ALF）的主要原因，尽管全球范围内的频率是可变的。APAP肝毒性在几个因素的背景下，如伴随使用酒精和某些促进反应性和毒性代谢产物形成的药物，在故意过量或无意摄入（治疗事故）后发生。与非APAP原因相比，APAP诱导的ALF的自发存活更常见。N-乙酰半胱氨酸被推荐用于所有APAP诱导的ALF患者，并降低死亡率。肝移植应尽早提供给那些谁不太可能生存的基础上描述的预后标准。
Acetaminophen (APAP) is the leading cause of acute liver failure (ALF), although the worldwide frequency is variable. APAP hepatotoxicity develops either following intentional overdose or unintentional ingestion (therapeutic misadventure) in the background of several factors, such as concomitant use of alcohol and certain medications that facilitate the formation of reactive and toxic metabolites. Spontaneous survival is more common in APAP-induced ALF compared with non-APAP causes. N-acetylcysteine is recommended for all patients with APAP-induced ALF, and it reduces mortality. Liver transplant should be offered early to those who are unlikely to survive based on described prognostic criteria.