难治性原发性胆汁性胆管炎的早期评估与治疗进展  

Advances in the early evaluation and treatment of refractory primary biliary cholangitis

作　　者：朱会灵 郑梦瑶[1] 雷红涛 赵娅芳 王霞[1] 杨晋辉[1] ZHU Huiling;ZHENG Mengyao;LEI Hongtao;ZHAO Yafang;WANG Xia;YANG Jinhui(Department of Gastroenterology,the Second Affiliated Hospital of Kunming Medical Universit,Yunnan 650106;Public Health College,Kunming Medical University,China)

机构地区：[1]昆明医科大学第二附属医院消化内科,云南昆明650106 [2]昆明医科大学公共卫生学院

出　　处：《胃肠病学和肝病学杂志》2023年第9期1074-1078,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：昆明医科大学第二附属医院院内临床项目(ynllT2021001)。

摘　　要：原发性胆汁性胆管炎(primary biliary cholangitis,PBC)是以胆管上皮损伤、肝内胆汁淤积为特点的慢性自身免疫性肝病,熊去氧胆酸(ursodeoxycholic acid,UDCA)是目前治疗PBC的一线药物。然而,临床约40%的PBC患者对UDCA应答不佳,称为难治性PBC,因此,尽早判断UDCA治疗效果是临床亟待解决的问题。对于此类患者,应及早进行风险评估,并在UDCA治疗的基础上联合使用二线治疗药物,从而达到治疗目标。近年来,随着对PBC发病机制的进一步阐明,以及对胆汁酸代谢和免疫功能紊乱等靶向药物的研究,从而指导临床为难治性PBC患者制定合理的治疗方案。Primary biliary cholangitis(PBC)is an immune-mediated chronic liver disease characterized by biliary epithelial injury and intrahepatic cholestasis.And ursodeoxycholic acid(UDCA)is the first-line therapeutic drug for PBC patients.However,up to 40%of patients with PBC have an incomplete response to the first-line therapy called refractory PBC,which is an urgent clinical problem to evaluate the therapeutic effects of UDCA as soon as possible.For these patients,it is necessary to have early risk stratifications and additional treatments to reach therapeutic goals.Recently,as the mechanisms underlying the pathogenesis of PBC are further clarified,various therapies target bile acid homeosis and immune dysfunction are being studied.Both to guide the discovery of new therapies and to inform clinicians so that rational treatment regimens can be tailored to patients.

关 键 词：肝内胆汁淤积 预后模型 治疗 

分 类 号：R575[医药卫生—消化系统]