抗肝纤维化药物治疗研究进展  

Research Progress of Anti-Hepatic Fibrosis Drug Treatment

作　　者：石项天 欧阳晓晖 苏秀兰[2] SHI Xiangtian;OUYANG Xiaohui;SU Xiulan(Graduate School,Inner Mongolia University of Science and Technology Baotou Medical College,Baotou 014040,China;Clinical Medical Research Center,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Hepatobiliary,Pancreatic and Splenic Surgery,Inner Mongolia People′s Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014040 [2]内蒙古医科大学附属医院临床医学研究中心,呼和浩特010050 [3]内蒙古自治区人民医院肝胆胰脾外科,呼和浩特010017

出　　处：《医学综述》2019年第3期480-484,489,共6页Medical Recapitulate

基　　金：国家自然科学基金(81660468)

摘　　要：各种损伤因素持续作用引起肝脏细胞凋亡导致炎症反应。肝星状细胞(HSCs)激活并转变为肌纤维纤维细胞,使细胞外基质(ECM)过度沉积,导致局部肝小叶瘢痕形成,引起肝实质和血管结构变化及结节再生等是肝纤维化形成的主要特点,若不加以干预将进展为肝硬化。除肝细胞损伤因素外,使激活的HSCs减少或恢复至静止状态,导致过度沉积的ECM降解等是药物治疗肝纤维化的关键。药物可以通过抑制肝炎病毒复制、调节脂质代谢;减少HSCs激活,升高抗炎、抗氧化水平;调节ECM转化平衡向降解方向转变,对不同因素引起的肝纤维化过程进行干预治疗。目前,抗肝纤维化治疗仍以针对肝纤维化病因单一用药为主,未来可根据药物作用原理,多种药物联合应用,以提高疗效和降低药物剂量。The continuous action of various injury factors causes apoptosis of liver cells leading to an inflammatory response.Hepatic stellate cells(HSCs)are activated and transformed into myofibroblasts,causing excessive deposition of extracellular matrix(ECM),leading to local hepatic lobular scar formation,causing changes in liver parenchyma and vascular structure,and nodular regeneration,which are formed by hepatic fibrosis.The main feature,if not intervened,will progress to cirrhosis.In addition to hepatocyte injury factors,the reduction or recovery of activated HSCs to a resting state,resulting in excessive deposition of ECM degradation,etc.,is a key point for drug treatment of liver fibrosis.Drugs can inhibit the replication of hepatitis virus,regulate lipid metabolism;reduce the activation of HSCs,increase the anti-inflammatory and anti-oxidation levels;regulate the transition of ECM transformation to the direction of degradation,and intervene the process of liver fibrosis caused by different factors.At present,anti-hepatic fibrosis treatment is still based on the single drug targeted at the cause of hepatic fibrosis.In the future,according to the principle of drug action,multiple drugs can be combined to improve the efficacy and reduce the drug dosage.

关 键 词：抗肝纤维化 药物治疗 肝星状细胞 

分 类 号：R575.2[医药卫生—消化系统]