中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

原发性胆汁性胆管炎的临床特征与治疗分层管理

陈瑜 韩英

引用本文:
Citation:

原发性胆汁性胆管炎的临床特征与治疗分层管理

DOI: 10.3969/j.issn.1001-5256.2017.11.009
详细信息
  • 中图分类号: R575.22

Clinical features of primary biliary cholangitis and stratified treatment management

  • 摘要: 原发性胆汁性胆管炎(PBC)是一种异质性相对较强的疾病,不同患者的临床经过及表型可能存在较大差异。因此,必须给予长期的治疗和随访才能对患者进行准确的危险分层。通过观察PBC患者临床症状、检测指标的变化,对不同患者进行个体化的管理,才能使低风险的PBC患者得到规范化治疗,使高风险患者可能从各种精心设计的临床研究中获益。

     

  • [1]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.
    [2]LINDOR KD, GERSHWIN ME, POUPON R, et al.Primary biliary cirrhosis[J].Hepatology, 2009, 50 (1) :291-308.
    [3]TRIVEDI PJ, LAMMERS WJ, van BUUREN HR, et al.Stratification of hepatocellular carcinoma risk in primary biliary cirrhosis:a multicentre international study[J].Gut, 2016, 65 (2) :321-329.
    [4]CARBONE M, MELLS GF, PELLS G, et al.Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid[J].Gastroenterology, 2013, 144 (3) :560-569.e7.
    [5]CHEUNG A, LAMMERS WJ, HIRSCHFIELD GM, et al.Age, bilirubin and albumin, regardless of sex, are the strongest independent predictors of biochemical response and transplantation-free survival in patients with primary biliary cirrhosis[J].J Hepatol, 2015, 62:s798.
    [6]PRINCE M, CHETWYND A, NEWMAN W, et al.Survival and symptom progression in a geographically based cohort of patients with primary biliary cirrhosis:follow-up for up to 28 years[J].Gastroenterology, 2002, 123 (4) :1044-1051.
    [7]de LISO F, MATINATO C, RONCHI M, et al.The diagnostic accuracy of biomarkers for diagnosis of primary biliary cholangitis (PBC) in anti-mitochondrial antibody (AMA) -negative PBCpatients:a review of literature[J].Clin Chem Lab Med, 2017.[Epub ahead of print]
    [8]LAMMERS WJ, van BUUREN HR, HIRSCHFIELD GM, et al.Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis:an international follow-up study[J].Gastroenterology, 2014, 147:1338-1349.
    [9] TRIVEDI PJ, BRUNS T, CHEUNG A, et al.Optimising risk stratification in primary biliary cirrhosis:AST/plateletratio index predicts outcome independent of ursodeoxycholic acid response[J].JHepatol, 2014, 60 (6) :1249-1258.
    [10]NAKAMURA M, KONDO H, MORI T, et al.Anti-gp210 and anticentromere antibodies are different risk factors for the progression of primary biliary cirrhosis[J].Hepatology, 2007, 45 (1) :118-127.
    [11]ZHANG LN, SHI TY, SHI XH, et al.Early biochemical response to ursodeoxycholic acid and long-term prognosis of primary biliary cirrhosis:results of a 14-year cohort study[J].Hepatology, 2013, 58 (1) :264-272.
    [12]FLOREANI A, FRANCESCHET I, CAZZAGON N, et al.Extrahepatic autoimmune conditions associated with primary biliary cirrhosis[J].Clin Rev Allergy Immunol, 2015, 48 (2-3) :192-197.
    [13]BOBERG KM, CHAPMAN RW, HIRSCHFIELD GM, et al.Overlap syndromes:the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue[J].J Hepatol, 2011, 54 (2) :374-385.
    [14]European Association for the Study of the Liver.EASL Clinical Practice Guidelines:the diagnosis and managementof patients with primary biliary cholangitis[J].J Hepatol, 2017, 67 (1) :145-172.
    [15]LAMMERS WJ, HIRSCHFIELD GM, CORPECHOT C, et al.Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy[J].Gastroenterology, 2015, 149 (7) :1804-1812.
    [16]CARBONE M, SHARP SJ, FLACK S, et al.The UKPBC risk scores:derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cirrhosis[J].Hepatology, 2016, 63 (3) :930-950
    [17]CORPECHOT C, ABENAVOLI L, RABAHI N, et al.Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis[J].Hepatology, 2008, 48 (3) :871-877.
    [18]PARES A, CABALLERIA L, RODES J.Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid[J].Gastroenterology, 2006, 130 (3) :715-720.
    [19]CORPECHOT C, CHAZOUILLERES O, POUPON R.Early primary biliary cirrhosis:biochemical response to treatment and prediction of long-term outcome[J].J Hepatol, 2011, 55 (6) :1361-1367.
    [20]KUMAGI T, GUINDI M, FISCHER SE, et al.Baseline ductopenia and treatment response predict long-term histological progression in primary biliary cirrhosis[J].Am J Gastroenterol, 2010, 105 (10) :2186-2194.
    [21]TRIVEDI PJ, BRUNS T, CHEUNG A, et al.Optimising risk stratification in primary biliary cirrhosis:AST/platelet ratio index predicts outcome independent of ursodeoxycholic acid response[J].JHepatol, 2014, 60 (6) :1249-1258.
    [22]HUET PM, VINCENT C, DESLAURIER J, et al.Portal hypertension and primary biliary cirrhosis:effect of long-term ursodeoxycholic acid treatment[J].Gastroenterology, 2008, 135 (50) :1552-1560.
    [23]KAKUDA Y, HARADA K, SAWADA-KITAMURA S, et al.E-valuation of a new histologic staging and grading system for primary biliary cirrhosis in comparison with classical systems[J].Hum Pathol, 2013, 44 (6) :1107-1117.
    [24]WENDUM D, BOELLE PY, BEDOSSA P, et al.Primary biliary cirrhosis:proposal for a new simple histological scoring system[J].Liver Int, 2015, 35 (2) :652-659.
    [25]CORPECHOT C, CARRAT F, POUJOL-ROBERT A, et al.Noninvasive elastography-based assessment ofliver fibrosis progression and prognosis in primary biliary cirrhosis[J].Hepatology, 2012, 56 (1) :198-208.
    [26]FLOREANI A, CAZZAGON N, MARTINES D, et al.Performance and utility of transient elastography and noninvasive markers of liver fibrosis in primary biliary cirrhosis[J].Dig Liver Dis, 2011, 43 (11) :887-892
    [27]MAYO M, PARKES J, ADAMS-HUET B, et al.Prediction of clinical outcomes in primary biliary cirrhosis by serum enhanced liver fibrosis (ELF) assay[J].Hepatology, 2008, 48 (5) :1549-1557.
    [28] NEVENS F, ANDREONE P, MAZZELLA G, et al.A placebo-controlled trial of obeticholic acid in primary biliary cholangitis[J].N Engl J Med, 2016, 375 (7) :631-643.
    [29]SAMUR S, KLEBANOFF M, BANKEN R, et al.Long-term clinical impact and cost-effectiveness of obeticholic acid for the treatment of primary biliary cholangitis[J].Hepatology, 2017, 65 (3) :920-928.
    [30]DHANDA A, LEE R, COLLINS P.Is primary biliary cirrhosis a steroid-sensitive autoimme disease?[J].Hepatol Res, 2012, 42 (6) :619-620.
    [31]IWASAKI S, TSUDA K, UETA H, et al.Benzafibrate may have beneficial effect in pre-cirrhotic primary biliary cirrhosis[J].Hepatol Res, 1999, 16 (1) :12-18.
    [32]RUDIC JS, POROPAT G, KRSTIC MN, et al.Bezafibrate for primary biliary cirrhosis[J].Cochrane Database Syst Rev, 2012, 1:cd450091.
    [33]GRIGORIAN AY, MARDINI HE, CORPECHOT C, et al.Fenofibrate is effective adjunctive therapy in the treatment of primary biliary cirrhosis:a meta-analysis[J].Clin Res Hepatol Gastroenterol, 2015, 39 (3) :296-306.
    [34]PHILLIPS JR, ANGULO P, PETTERSON T, et al.Fat-soluble vitamin levels in patients with primary biliary cirrhosis[J].Am JGastroenterol, 2001, 96 (9) :2745-2750.
    [35]MAILLETTE de BWL, BEUERS U.Bile salts and cholestasis[J].Dig Liver Dis, 2010, 42 (6) :409-418.
    [36]TRIVEDI PJ, CORPECHOT C, PARES A, et al.Risk stratification in autoimmune cholestatic liver diseases:opportunities for clinicians and trialists[J].Hepatology, 2016, 63 (2) :644-659.
    [37]ADAM R, KARAM V, DELVART V, et al.Evolution of indications and results of liver transplantation in Europe.A report from the European Liver Transplant Registry (ELTR) [J].J Hepatol, 2012, 57 (3) :675-688.
    [38]GAUTAM M, CHERUVATTATH R, BALAN V.Recurrence of autoimmune liver disease after liver transplantation:a systematic review[J].Liver Transpl, 2006, 12 (12) :1813-1824.
    [39]HUBSCHER SG, ELIAS E, BUCKELS JA, et al.Primary biliary cirrhosis.Histological evidence of disease recurrence after liver transplantation[J].J Hepatol, 1993, 18 (2) :173-184.
    [40]BOSCH A, DUMORTIER J, MAUCORT-BOULCH D, et al.Preventive administration of UDCA after liver transplantation for primary biliary cirrhosis is associated with a lower risk of disease recurrence[J].J Hepatol, 2015, 63 (6) :1449-1458.
  • 加载中
计量
  • 文章访问数:  2540
  • HTML全文浏览量:  34
  • PDF下载量:  671
  • 被引次数: 0
出版历程
  • 收稿日期:  2017-08-06
  • 出版日期:  2017-11-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回