当地时间3月7日8:00，第29届亚太肝病学会年会（APASL2020）“重症肝病监护专题研讨会”于印度尼西亚巴厘岛如期举行，以肝炎病毒感染及对DILI的影响、肝硬化的呼吸衰竭、结核病药物DILI的预防与评估，以及肝硬化的真菌感染这四个话题展开，分享最新进展和观点，并对相关问题进行讨论。本届大会主席、印度尼西亚大学Rino A. Gani教授在接受《国际肝病》记者采访，分享了会上关于肝硬化真菌感染的讨论内容，详见下文。

 

tips：收听英文可以滑动文章学习英文呦！

 

哪些患者存在肝硬化真菌感染风险？

 

Rino A. Gani教授：对于免疫功能低下的患者，例如肝移植后患者，真菌感染的风险增加。我们还必须记住，真菌感染会导致肝硬化患者出现并发症。肝硬化本身可能会损害免疫功能，因此我们必须警惕真菌感染的发生时机，尤其是长期使用抗生素的患者。关于肝硬化患者的管理，这一点是我们必须记住的。

 

原文呈现：

 

<Hepatology Digest>: What are the risk factors associated with fungal infection in patients with cirrhosis?

 

Dr Gani: For patients who are immunocompromised, such as patients post-liver transplantation, the risk of fungal infections increases. We also have to remember that fungal infections can cause complications in patients with liver cirrhosis. Liver cirrhosis itself can be immune compromising, so we have to pay attention to the chance of fungal infections occurring, especially in patients with long-term antibiotic use. That is something we have to remember in patients with liver cirrhosis.

 

如何早期诊断和治疗肝硬化真菌感染？

 

Rino A. Gani教授：研究表明，早期抗真菌治疗将增加患有真菌感染的肝硬化患者的治愈的可能性。如果患者有真菌感染的危险因素，应尝试用半乳甘露聚糖或β-D-葡聚糖（beta-D-glucan）生物标志物来进行早期诊断。关于治疗，需要考虑选择肝毒性较小的药物，可以首选使用阿尼芬净（anidulafungin）或米卡芬净（micafungin）。

 

原文呈现：

 

<Hepatology Digest>: What other factors should be considered in the early diagnosis and treatment of fungal infections?

 

Dr Gani: Studies show that early treatment with antifungal therapy will increase the likelihood of healing in patients with liver cirrhosis with a fungal infection. If a patient has risk factors for fungal infections, early diagnosis should be sought with either galactomannan or beta-D-glucan biomarkers. For treatment, the use of anidulafungin or micafungin may be preferable for these patients, because of their lesser hepatotoxicity.