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原发性胆汁性胆管炎相关瘙痒症的管理

胡凯丽 肖丽

引用本文:
Citation:

原发性胆汁性胆管炎相关瘙痒症的管理

DOI: 10.3969/j.issn.1001-5256.2021.04.049
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:胡凯丽负责资料准备、收集与分析以及论文的撰写;肖丽负责修改论文。
详细信息
    作者简介:

    胡凯丽(1993—),女,主要从事全科医学方面的研究

    通信作者:

    肖丽,xiaoli24tz@163.com

  • 中图分类号: R575.22

Management of pruritus in primary biliary cholangitis

  • 摘要: 原发性胆汁性胆管炎(PBC)是一种进行性肝内胆汁淤积性自身免疫性疾病,瘙痒可见于60%~70%的PBC患者,并严重影响患者的生活质量。改善PBC患者的瘙痒症状对提高患者的生活质量有着重要意义。主要总结了PBC的发病机制、PBC相关瘙痒症的治疗进展。

     

  • [1] 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. DOI: 10.1053/gast.2002.36027.
    [2] QUARNETI C, MURATORI P, LALANNE C, et al. Fatigue and pruritus at onset identify a more aggressive subset of primary biliary cirrhosis[J]. Liver Int, 2015, 35(2): 636-641. DOI: 10.1111/liv.12560.
    [3] LANZINI A, de TAVONATTI MG, PANAROTTO B, et al. Intestinal absorption of the bile acid analogue 75Se-homocholic acid-taurine is increased in primary biliary cirrhosis, and reverts to normal during ursodeoxycholic acid administration[J]. Gut, 2003, 52(9): 1371-1375. DOI: 10.1136/gut.52.9.1371.
    [4] BEUERS U, KREMER AE, BOLIER R, et al. Pruritus in cholestasis: Facts and fiction[J]. Hepatology, 2014, 60(1): 399-407. DOI: 10.1002/hep.26909.
    [5] HEGADE VS, BOLIER R, OUDE ELFERINK RP, et al. A systematic approach to the management of cholestatic pruritus in primary biliary cirrhosis[J]. Frontline Gastroenterol, 2016, 7(3): 158-166. DOI: 10.1136/flgastro-2015-100618.
    [6] TAJIRI K, SHIMIZU Y. Recent advances in the management of pruritus in chronic liver diseases[J]. World J Gastroenterol, 2017, 23(19): 3418-3426. DOI: 10.3748/wjg.v23.i19.3418.
    [7] LIU XY, LIU ZC, SUN YG, et al. Unidirectional cross-activation of GRPR by MOR1D uncouples itch and analgesia induced by opioids[J]. Cell, 2011, 147(2): 447-458. DOI: 10.1016/j.cell.2011.08.043.
    [8] GRAND'MAISON S, DURAND M, MAHONE M. The effects of ursodeoxycholic acid treatment for intrahepatic cholestasis of pregnancy on maternal and fetal outcomes: A meta-analysis including non-randomized studies[J]. J Obstet Gynaecol Can, 2014, 36(7): 632-641. DOI: 10.1016/S1701-2163(15)30544-2.
    [9] European Association for the Study of the Liver. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol, 2017, 67(1): 145-172. DOI: 10.1016/j.jhep.2017.03.022.
    [10] BERGASA NV. The pruritus of cholestasis[J]. J Hepatol, 2005, 43(6): 1078-1088. DOI: 10.1016/j.jhep.2005.09.004.
    [11] DATTA DV, SHERLOCK S. Treatment of pruritus of obstructive jaundice with cholestyramine[J]. Br Med J, 1963, 1(5325): 216-219. DOI: 10.1136/bmj.1.5325.216.
    [12] KUIPER EM, van ERPECUM KJ, BEUERS U, et al. The potent bile acid sequestrant colesevelam is not effective in cholestatic pruritus: Results of a double-blind, randomized, placebo-controlled trial[J]. Hepatology, 2010, 52(4): 1334-1340. DOI: 10.1002/hep.23821.
    [13] GHENT CN, CARRUTHERS SG. Treatment of pruritus in primary biliary cirrhosis with rifampin. Results of a double-blind, crossover, randomized trial[J]. Gastroenterology, 1988, 94(2): 488-493. http://gut.bmj.com/external-ref?access_num=3275568&link_type=MED
    [14] PODESTA A, LOPEZ P, TERG R, et al. Treatment of pruritus of primary biliary cirrhosis with rifampin[J]. Dig Dis Sci, 1991, 36(2): 216-220. DOI: 10.1007/BF01300759.
    [15] TANDON P, ROWE BH, van der MEER B, et al. The efficacy and safety of bile acid binding agents, opioid antagonists, or rifampin in the treatment of cholestasis-associated pruritus[J]. Am J Gastroenterol, 2007, 102(7): 1528-1536. DOI: 10.1111/j.1572-0241.2007.01200.x.
    [16] KHURANA S, SINGH P. Rifampin is safe for treatment of pruritus due to chronic cholestasis: A meta-analysis of prospective randomized-controlled trials[J]. Liver Int, 2006, 26(8): 943-948. DOI: 10.1111/j.1478-3231.2006.01326.x.
    [17] SHAH RA, KOWDLEY KV. Mechanisms and treatments of pruritus in primary biliary cholangitis[J]. Semin Liver Dis, 2019, 39(2): 209-220. DOI: 10.1055/s-0039-1679918.
    [18] PONGCHAROEN P, FLEISCHER AB Jr. An evidence-based review of systemic treatments for itch[J]. Eur J Pain, 2016, 20(1): 24-31. DOI: 10.1002/ejp.766.
    [19] WOLFHAGEN FH, STERNIERI E, HOP WC, et al. Oral naltrexone treatment for cholestatic pruritus: A double-blind, placebo-controlled study[J]. Gastroenterology, 1997, 113(4): 1264-1269. DOI: 10.1053/gast.1997.v113.pm9322521.
    [20] TERG R, CORONEL E, SORDÁ J, et al. Efficacy and safety of oral naltrexone treatment for pruritus of cholestasis, a crossover, double blind, placebo-controlled study[J]. J Hepatol, 2002, 37(6): 717-722. DOI: 10.1016/s0168-8278(02)00318-5.
    [21] 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. DOI: 10.1016/j.jhep.2009.04.009.
    [22] MCRAE CA, PRINCE MI, HUDSON M, et al. Pain as a complication of use of opiate antagonists for symptom control in cholestasis[J]. Gastroenterology, 2003, 125(2): 591-596. DOI: 10.1016/s0016-5085(03)00879-5.
    [23] BROWNING J, COMBES B, MAYO MJ. Long-term efficacy of sertraline as a treatment for cholestatic pruritus in patients with primary biliary cirrhosis[J]. Am J Gastroenterol, 2003, 98(12): 2736-2741. DOI: 10.1111/j.1572-0241.2003.08662.x.
    [24] MAYO MJ, HANDEM I, SALDANA S, et al. Sertraline as a first-line treatment for cholestatic pruritus[J]. Hepatology, 2007, 45(3): 666-674. DOI: 10.1002/hep.21553.
    [25] JONES EA, MOLENAAR HA, OOSTING J. Ondansetron and pruritus in chronic liver disease: A controlled study[J]. Hepatogastroenterology, 2007, 54(76): 1196-1199. http://www.ncbi.nlm.nih.gov/pubmed/17629069
    [26] BARRY DM, MUNANAIRI A, CHEN ZF. Spinal mechanisms of itch transmission[J]. Neurosci Bull, 2018, 34(1): 156-164. DOI: 10.1007/s12264-017-0125-2.
    [27] KREMER AE, MARTENS JJ, KULIK W, et al. Lysophosphatidic acid is a potential mediator of cholestatic pruritus[J]. Gastroenterology, 2010, 139(3): 1008-1018. DOI: 10.1053/j.gastro.2010.05.009.
    [28] HEGADE VS, KRAWCZYK M, KREMER AE, et al. The safety and efficacy of nasobiliary drainage in the treatment of refractory cholestatic pruritus: A multicentre European study[J]. Aliment Pharmacol Ther, 2016, 43(2): 294-302. DOI: 10.1111/apt.13449.
    [29] KRAWCZYK M, LIEBE R, WASILEWICZ M, et al. Plasmapheresis exerts a long-lasting antipruritic effect in severe cholestatic itch[J]. Liver Int, 2017, 37(5): 743-747. DOI: 10.1111/liv.13281.
    [30] PARÉS A, HERRERA M, AVILÉS J, et al. Treatment of resistant pruritus from cholestasis with albumin dialysis: Combined analysis of patients from three centers[J]. J Hepatol, 2010, 53(2): 307-312. DOI: 10.1016/j.jhep.2010.02.031.
    [31] KHUNGAR V, GOLDBERG DS. Liver transplantation for cholestatic liver diseases in adults[J]. Clin Liver Dis, 2016, 20(1): 191-203. DOI: 10.1016/j.cld.2015.08.011.
    [32] REIG A, SESÉ P, PARÉS A. Effects of bezafibrate on outcome and pruritus in primary biliary cholangitis with suboptimal ursodeoxycholic acid response[J]. Am J Gastroenterol, 2018, 113(1): 49-55. DOI: 10.1038/ajg.2017.287.
    [33] CORPECHOT C, CHAZOUILLÈRES O, ROUSSEAU A, et al. A placebo-controlled trial of bezafibrate in primary biliary cholangitis[J]. N Engl J Med, 2018, 378(23): 2171-2181. DOI: 10.1056/NEJMoa1714519.
    [34] LINDOR KD, BOWLUS CL, BOYER J, et al. Primary biliary cholangitis: 2018 practice guidance from the American Association for the study of liver diseases[J]. Hepatology, 2019, 69(1): 394-419. DOI: 10.1002/hep.30145.
    [35] HEGADE VS, KENDRICK SF, DOBBINS RL, et al. BAT117213: Ileal bile acid transporter (IBAT) inhibition as a treatment for pruritus in primary biliary cirrhosis: Study protocol for a randomised controlled trial[J]. BMC Gastroenterol, 2016, 16(1): 71. DOI: 10.1186/s12876-016-0481-9.
    [36] MAYO MJ, POCKROS PJ, JONES D, et al. A randomized, controlled, phase 2 study of Maralixibat in the treatment of itching associated with primary biliary cholangitis[J]. Hepatol Commun, 2019, 3(3): 365-381. DOI: 10.1002/hep4.1305.
    [37] HEGADE VS, KENDRICK SF, DOBBINS RL, et al. Effect of ileal bile acid transporter inhibitor GSK2330672 on pruritus in primary biliary cholangitis: A double-blind, randomised, placebo-controlled, crossover, phase 2a study[J]. Lancet, 2017, 389(10074): 1114-1123. DOI: 10.1016/S0140-6736(17)30319-7.
    [38] KUMADA H, MIYAKAWA H, MURAMATSU T, et al. Efficacy of nalfurafine hydrochloride in patients with chronic liver disease with refractory pruritus: A randomized, double-blind trial[J]. Hepatol Res, 2017, 47(10): 972-982. DOI: 10.1111/hepr.12830.
    [39] KAMIMURA K, YOKOO T, KAMIMURA H, et al. Long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients: Patient-reported outcome based analyses[J]. PLoS One, 2017, 12(6): e0178991. DOI: 10.1371/journal.pone.0178991.
    [40] DECOCK S, ROELANDTS R, STEENBERGEN WV, et al. Cholestasis-induced pruritus treated with ultraviolet B phototherapy: An observational case series study[J]. J Hepatol, 2012, 57(3): 637-641. DOI: 10.1016/j.jhep.2012.04.023.
    [41] MAIONE S, COSTA B, di MARZO V. Endocannabinoids: A unique opportunity to develop multitarget analgesics[J]. Pain, 2013, 154(Suppl 1): s87-s93. DOI: 10.1016/j.pain.2013.03.023.
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  • 收稿日期:  2020-09-22
  • 录用日期:  2020-10-19
  • 出版日期:  2021-04-20
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