肝纤维化与慢性肝病的治疗  

The therapy for hepatic fibrosis and chronic liver diseases

作　　者：成扬[1] 

机构地区：[1]上海中医药大学附属曙光医院东院肝病研究所,上海201203

出　　处：《世界感染杂志》2007年第1期10-12,34,共4页World Journal of Infection

基　　金：基金项目：国家自然科学基金项目（30300458）.

摘　　要：乙型肝炎病毒感染极易慢性化，可演变发展为肝硬化和为肝癌。抗病毒治疗能够在一定程度上抑制病毒复制，促使肝病缓解，但并不能彻底清除病毒。肝纤维化是向肝硬化发展的必经之路。肝星状细胞活化是肝纤维化发生的核心事件，激活途径有旁分泌途径和自分泌途径两种形式。自分泌途径一旦开放，即使没有病因的进一步刺激，肝纤维化仍然能够主动进展，因此病因治疗并不能够完全替代抗肝纤维化治疗。促进活化肝星状细胞凋亡是肝纤维化逆转的中心环节。抗肝纤维化与抗病毒治疗起着协同作用，既有利于病毒的抑制与清除，也有利于肝组织病理损伤的改善与修复，延缓或者阻止肝硬化的形成。Hepatitis B virus （HBV） infection can lead to chronic infection, liver cirrhosis and hepatocellular carcinoma. Anti-HBV therapy can inhibit viral reproduction to some extent and alleviate liver injury, but cannot eradicate the virus completely, Hepatic fibrosis is the inevitable process to liver cirrohsis and the activatiort of hepatic stellate ceils （HSC） is the central event during hepatic fibrogenesis. The HSC activation routes incude the paracrine and aoutocrine route. Once the autocdne route is induced, hepatic fibrogenesis will progress initiatively if not intervened effectively, The treatment aiming to pathogenes cannot replace anti-hepatic fibrosis treatment. To accelerate the apoptosis of activated HSC is the key in reversing hepatic fibrosis. Anti-hepatic fibrosis and anti-HBV treatment can receive synergetic effect, not only aiding to HBV inhibition and eradication but also helping to the recorvery of liver pahlogical changes, so that to delay or stop the formation of liver cirrhosis.

关 键 词：慢性乙型肝炎 肝纤雏化 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]