主要胆汁硬化
Elizabeth J Carey1, Ahmad H Ali1, Keith D Lindor2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
Lancet (London, England)
|September 15, 2015
概括
主要胆汁硬化 (PBC) 是一种慢性肝病. 虽然ursodeoxycholic acid (UDCA) 改善了存活率,但对于没有反应的人来说,需要新的治疗方法,核受体激素显示出有前途.
科学领域:
- 肝病学
- 免疫学
- 胃肠病学
背景情况:
- 初级胆管硬化 (PBC) 是一种慢性胆固醇性肝病,其特征是自身免疫性小胆管的破坏.
- 抗线粒体抗体 (AMA) 是一种特定的血清标志物,存在于约95%的PBC患者中.
- 疲劳和是常见的症状,无论疾病的严重程度如何.
研究的目的:
- 审查目前对PBC流行病学,病变和自然史的理解.
- 讨论PBC目前的管理策略和并发症.
- 介绍新兴的治疗方案,包括对核受体激素的研究.
主要方法:
- 对原发性胆汁硬化现有文献的综述.
- 临床试验数据的分析,以测试ursodeoxycholic acid (UDCA) 的疗效.
- 对新型治疗点的研究成果的探索.
主要成果:
- 在PBC患者中改善了无移植存活率.
- 大约40%的PBC患者对UDCA的生化反应不足.
- 肝脏移植为没有补偿的肝硬化患者提供了很好的结果.
结论:
- 尽管UDCA有好处,但很大一部分PBC患者需要替代治疗.
- 对核受体激素的研究为新的PBC疗法提供了有前途的途径.
- 了解PBC的各个方面对于改善患者护理至关重要.
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