Cirrhosis-associated immune dysfunction refers to the concurrent systemic inflammation and immunoparesis evident across the disease spectrum of chronic liver disease, ranging from the low-grade inflammatory plasma milieu that accompanies compensated disease to the intense high-grade inflammatory state with coexistent severe immune paralysis that defines acute decompensation and acute-on-chronic liver failure. Systemic inflammation plays a crucial role in the disease course of cirrhosis and is a key driver for acute decompensation and the progression from compensated to decompensated cirrhosis. Severe systemic inflammation is fundamental to the development of organ dysfunction and failure and, in its most extreme form, acute-on-chronic liver failure. Systemic inflammation propagates the development of hepatic encephalopathy and hepatorenal syndrome-acute kidney injury. It may also be involved in the pathogenesis of further complications such as hepatocellular carcinoma and mental illness. Those patients with the most profound systemic inflammation have the worst prognosis. Systemic inflammation exerts its negative clinical effects through a number of mechanisms including nitric oxide-mediated increased splanchnic vasodilation, immunopathology, and metabolic reallocation.

中文翻译：

---

肝硬化患者炎症的临床意义。


肝硬化相关免疫功能障碍是指在慢性肝病的疾病谱中明显的并发全身炎症和免疫轻瘫，范围从伴随代偿性疾病的低级别炎症血浆环境到伴有严重免疫麻痹的强烈高级别炎症状态，定义急性失代偿和慢加急性肝衰竭。全身性炎症在肝硬化的病程中起着至关重要的作用，是急性失代偿和从代偿期向失代偿期肝硬化进展的关键驱动因素。严重的全身炎症是器官功能障碍和衰竭发展的基础，在最极端的形式中，是慢加急性肝衰竭。全身性炎症传播肝性脑病和肝肾综合征-急性肾损伤的发展。它还可能参与进一步并发症的发病机制，例如肝细胞癌和精神疾病。那些全身炎症最严重的患者预后最差。全身性炎症通过多种机制发挥其负面临床影响，包括一氧化氮介导的内脏血管舒张增加、免疫病理学和代谢重新分配。