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慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)是一组由慢性肝病为基础、急性肝内外损伤为诱因、伴有多器官功能衰竭和早期高病死率为特点的临床综合征.由于免疫功能紊乱(过度的免疫炎症反应重叠免疫功能障碍),肠道细菌过度生长/菌群紊乱,肠内菌群/相关细菌产物的易位等病理生理学特点,ACLF易发生感染.感染是诱发ACLF以及死亡的主要原因之一.合理的经验性抗菌素治疗在感染相关ACLF管理中起着至关重要的作用.

Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute decompensation of chronic liver disease associating with multiple organ failures and high short-term mortality.Patients with ACLF are highly susceptible to infection due to the pathophysiology features including immune function disorder (overlap of excessive inflammatory reaction and immune dysfunction),gut bacterial overgrowth/dysbiosis and translocation of gut microbiota/products.Appropriate empirical antibiotics plays a pivotal role in the management of ACLF with infection.