肝脏碱性磷酸酶:胆汁淤积和胆道损伤的标志物  

Liver alkaline phosphatase: a marker of cholestasis and bile duct injury

作　　者：沈斐斐[1] 陆伦根[1] 

机构地区：[1]上海交通大学附属第一人民医院消化科,上海200080

出　　处：《临床肝胆病杂志》2016年第5期1026-1030,共5页Journal of Clinical Hepatology

摘　　要：血清ALP不仅可以作为胆汁淤积症的评判指标,也可以作为评估原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)(PBC)和原发性硬化性胆管炎(PSC)及一些胆汁淤积性肝病病情严重程度的替代指标。介绍了健康人群及胆汁淤积性肝病患者其肝脏ALP的作用机制。在炎症引起的胆汁淤积情况下,酸性环境以及毛细胆管的重定位导致肝脏ALP活性缺失,脂多糖积聚增多,从而引起炎症的恶化及迁延不愈。在PBC和PSC的治疗中,促进肝细胞极性的恢复、促进毛细胆管胆汁酸的排出以及调节胆汁酸碱度的药物均能起到较好的抗炎作用。口服肠道ALP治疗胆汁淤积性疾病值得在实验室和临床中进一步验证。Studies show that serum alkaline phosphatase（ ALP） can be used not only to evaluate cholestasis,but also as a surrogate marker to assess the severity of primary biliary cirrhosis（ PBC）,primary sclerosing cholangitis（ PSC）,and several cholestatic liver diseases. This article introduces the mechanisms of action of liver ALP in the healthy population and patients with cholestatic liver disease. In case of cholestasis caused by inflammation,acidic environment and relocation of the bile capillaries cause liver ALP deactivation and an increased accumulation of lipopolysaccharide and thus lead to aggravation and delayed healing. In the treatment of PBC and PSC,promoting the restoration of hepatocyte polarity and the elimination of bile acid through the bile capillaries and using drugs capable of adjusting the p H of bile can achieve a good anti- inflammatory effect. The effect of oral intestinal ALP in the treatment of cholestatic diseases awaits further investigations in laboratories and in clinical practice.

关 键 词：碱性磷酸酶 胆汁淤积 肝硬化 胆汁性 胆管炎 硬化性 综述 

分 类 号：R575.6[医药卫生—消化系统]