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自免疫性肝炎的治疗方法
1Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, CA 94043, USA.
Clinics in liver disease
|November 9, 2023
概括
自免疫性肝炎的治疗目的是使用皮质类固醇和类固醇节约剂缓解肝炎. 治疗中断是罕见的,而晚期疾病可能需要进行肝移植.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 自身免疫性肝炎 (AIH) 是一种慢性肝病,需要长期管理.
- 治疗AIH的主要目标是实现临床和生化缓解,以改善患者的治疗结果.
研究的目的:
- 审查自身免疫性肝炎的护理标准和替代治疗策略.
- 讨论治疗中止的可行性和肝移植在先进AIH中的作用.
主要方法:
- 关于自身免疫性肝炎治疗方案的当前文献的综述.
- 对标准护理的诱导和维持疗法的分析.
- 对二线药物的评估和治疗中止标准.
主要成果:
- 皮质类固醇紧随其后的类固醇节约剂是对AIH的标准护理.
- 替代药物如mycophenolate mofetil,tacrolimus和rituximab用于不耐受或不充分的反应.
- 只有不到20%的患者在缓解两年后成功停止治疗.
结论:
- 在AIH中实现持续缓解是具有挑战性的,在治疗中断方面取得的成功有限.
- 肝移植是患有进展性AIH或肝细胞癌等并发症的患者的关键选择.
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