在脉冲类固醇治疗后,药物诱导的自身免疫性肝炎的长期结果
Masayuki Ueno1,2, Hiroyuki Takabatake1, Takahisa Kayahara1
1Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan.
概括
脉冲类固醇治疗可以导致药物诱导的自身免疫性肝炎 (DI-ALH),特别是在没有普雷迪尼索隆逐渐减少的情况下. 普雷尼索隆有效地治疗DI-ALH,允许缓解后的安全戒断.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 自免疫性疾病 自免疫性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 脉冲类固醇治疗有时与药物诱导的自身免疫性肝炎 (DI-ALH) 有关.
- 脉冲类固醇治疗后的DI-ALH患者的长期结果仍然不完全理解.
研究的目的:
- 为了研究脉冲类固醇治疗导致的药物诱导的自身免疫类肝炎 (DI-ALH) 的长期结果.
主要方法:
- 对405名接受脉冲高剂量甲基普雷迪尼索隆治疗的患者的回顾性分析.
- 在治疗后3个月内评估急性肝损伤的频率和特征.
- 基于修订的国际自身免疫性肝炎组标准的DI-ALH诊断.
主要成果:
- 在405名患者中,有61名患者 (15.1%) 患有急性肝损伤;在5名患者 (1.2%) 诊断出DI-ALH.
- 治疗后没有逐渐减少的口服普雷迪尼索隆是DI-ALH的重要危险因素 (OR 11.9,p=0.017).
- 缓解得到了glycyrrhizin或自发;在没有维持治疗的中位数34个月的随访期间,没有复发.
结论:
- 脉冲类固醇疗法可以使DI-ALH加速,特别是当随后的普雷迪尼索隆没有逐渐缩小时.
- 普雷尼索隆在治疗脉冲类固醇疗法诱导的DI-ALH时显示出有效性.
- 在DI-ALH患者中达到缓解后,可以安全地停止服用普雷尼索隆.
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