原发性胆汁性肝硬化的治疗进展

段维佳; 尤红

原发性胆汁性肝硬化的治疗进展

段维佳,
尤红

首都医科大学附属北京友谊医院肝病中心

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2621
- HTML全文浏览量: 20
- PDF下载量: 1181
- 被引次数: 0
出版历程
- 收稿日期: 2011-02-09
- 出版日期: 2011-06-20

Therapy advances in primary biliary cirrhosis

摘要

摘要: 原发性胆汁性肝硬化(PBC)是一种慢性肝内胆汁淤积性疾病。熊去氧胆酸(UDCA)是惟一经随机对照临床试验证实的治疗PBC安全有效的药物。经UDCA治疗1年后有较好生化应答的患者,其长期预后较好。目前,对UDCA应答欠佳患者的治疗方法尚不确定。肝移植是治疗终末期PBC患者惟一有效的方法。
- 肝硬化 /
- 胆汁性
Abstract: Primary biliary cirrhosis (PBC) is a chronic intrahepatic cholestatic disease.Ursodeoxycholic acid (UDCA) is the only safe and effective drug for the treatment of PBC proven by randomized controlled clinical trials.Favorable long-term effects of UDCA are observed in patients with good biochemical response after one year treatment.There is currently no consensus on how to treat patients with a suboptimal biochemical response to UDCA.Liver transplantation is the only therapeutic option for end-stage patients.
- liver cirrhosis /
- biliary

HTML全文

参考文献(23)

[1]Lindor KD, Gershwin ME, Poupon R, et al.Primary biliary cirrhosis[J].Hepatology, 2009, 50 (1) :291-308.

[2]European Association for the Study of the Liver.EASL Clinical Practice Guidelines:management of cholestatic liver diseases.[J].J Hepatol, 2009, 51 (2) :237-267.

[3]Parés A, Caballeíra L, Rodés J, et al.Excellent long-term sur-vival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic Acid[J].Gastroenterology, 2006, 130 (3) :715-720.

[4]Corpechot C, Chazouillères O, Poupon R, et al.Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis[J].Hepatology, 2008, 48 (3) :871-887.

[5]Kuiper EM, Hansen BE, de Vrios RA, et al.Improved prognosis of patients with primary biliary cirrhosis that have a biochemical response to ursodeoxychohc acid[J].Gastroenterology, 2009, 136 (4) :128l-1287.

[6]Babatin MA, Sanai FM, Swain MG.Methotrexate therapy for the symptomatic treatment of primary biliary cirrhosis patients, who are biochemical incomplete responders to ursodeoxycholic acid therapy[J].Aliment Pharmacol Ther, 2006, 24 (5) :813-820.

[7]Bonis PA, Kaplan M.Methotrexate improves biochemical tests in patients with primary biliary cirrhosis who respond incompletely to ursodiol[J].Gastroenterology.1999, 117 (2) :395-399.

[8]Kaplan MM, Bonder A, Ruthazer R, et al.Methotrexate in patients with primary biliary cirrhosis who respond incompletely to treatment with ursodeoxycholic acid[J].Dig Dis Sci, 2010, 55 (11) :3207-3217.

[9]Rautiainen H, Krkkinen P, Karvonen AL, et al.Budesonide combined with UDCA to improve liver histology in primary biliary cirrhosis:a three-year randomized trial[J].Hepatology, 2005, 41 (4) :747-752.

[10]Rabahi N, Chrétien Y, Gaouar F, et al.Triple therapy with ursodeoxycholic acid, budesonide and mycophenolate mofetil in patients with features of severe primary biliary cirrhosis not responding to ursodeoxycholic acid alone[J].Gastroenterol Clin Biol, 2010, 34 (4) :283-287.

[11]Talwalkar JA, Angulo P, Keach JC, et al.Mycophenolate mofetil for the treatment of primary biliary cirrhosis in patients with an incomplete response to ursodeoxycholic acid[J].J Clin Gastroenterol, 2005, 39 (2) :168-171.

[12]Levy C, Peter JA, Nelson DR, et al.Pilot study:fenofibrate for patients with primary biliary cirrhosis and an incomplete response to ursodeoxycholic acid[J].Aliment Pharmacol Ther, 2011, 33 (2) :235-242.

[13]Walker LJ, Newton J, Jones DE, et al.Comment on biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis[J].Hepatology, 2009, 49 (1) :337-338.

[14]Liberopoulos EN, Florentin M, Elisaf MS, et al.Fenofibrate in primary biliary cirrhosis:a pilot study[J].Open Cardiovasc Med J, 2010, 28 (4) :120-126.

[15]Iwasaki S, Ohira H, Nishiguchi S, et al.The efficacy of ursodeoxycholic acid and bezafibrate combination therapy for primary biliary cirrhosis:a prospective, multicenter study[J].Hepatol Res, 2008, 38 (6) :557-564.

[16]Hazzan R, Tur-Kaspa R.Bezafibrate treatment of primary biliary cirrhosis following incomplete response to ursodeoxycholic acid[J].J Clin Gastroenterol, 2010, 44 (5) :371-373.

[17]Wagner M, Halilbasic E, Marschall HU, et al.CAR and PXR agonists stimulate hepatic bile acid and bilirubin detoxification and elimination pathways in mice[J].Hepatology, 2005, 42 (2) :420-430.

[18]Awad AS, Kamel R.Effect of rosuvastatin on cholestasis-induced hepatic injury in rat livers[J].J Biochem Mol Toxicol, 2010, 24 (2) :89-94.

[19]Dold S, Laschke MW, Lavasani S, et al.Simvastatin protects against cholestasis-induced liver injury[J].J Pharmacol, 2009, 156 (3) :466-474.

[20]Stojakovic T, Putz-Bankuti C, Fauler G, et al.Atorvastatin in patients with primary biliary cirrhosis and incomplete biochemical response to ursodeoxycholic acid[J].Hepatology, 2007, 46 (3) :776-784.

[21]Rambaldi A, Jacobs BP, Gluud C.Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases[J].Cochrane Database Syst Rev, 2007, 17 (4) :CD003620.

[22]Angulo P, Patel T, Jorgensen RA, et al.Silymarin in the treatment of patients with primary biliary cirrhosis with a suboptimal response to ursodeoxycholic acid[J].Hepatology, 2000, 32 (2) :897-900.

[23]Angulo P, Jorgensen RA, Lindor KD.Incomplete response to ursodeoxycholic acid in primary biliary cirrhosis:is a double dosage worthwhile[J].Am J Gastroenterol, 2001, 96 (11) :152-157.

施引文献

资源附件(0)

访问统计