胆道纤维化的发生发展与治疗  

Pathogenesis,progression and treatment of biliary fibrosis

作　　者：赵进玉 林延延[2] 岳平[2] 姚佳[1] 米宁宁 李麻图 付文康 高龙 Azumi Suzuki Peng F Wong Kiyohito Tanaka Rungsun Rerknimitr Henrik H Junger Tan T Cheung Emmanuel Melloul Nicolas Demartines Joseph W Leung 袁金秋 Hans J Schlitt 孟文勃[2] Zhao Jinyu;Lin Yanyan;Yue Ping;Yao Jia;Mi Ningning;Li Matu;Fu Wenkang;Gao Long;Azumi Suzuki;Peng F Wong;Kiyohito Tanaka;Rungsun Rerknimitr;Henrik H Junger;Tan T Cheung;Emmanuel Melloul;Nicolas Demartines;Joseph W Leung;Yuan Jinqiu;Hans J Schlitt;Meng Wenbo(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730030,China;Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730030,China;Department of Gastroenterology,Hamamatsu Medical Center,Hamamatsu 432‐8002,Japan;Department of Vascular Surgery,The James Cook University Hospital,Middlesbrough TS43BW,UK;Department of Gastroenterology,Kyoto Second Red Cross Hospital,Kyoto 602‐8031,Japan;Excellence Center for Gastrointestinal Endoscopy,King Chulalongkorn Memorial Hospital,Bangkok 10330,Thailand;Department of Surgery,University Medical Center Regensburg,Regensburg 93053,Germany;Department of Surgery,the University of Hong Kong,Hong Kong 999077,China;Department of Visceral Surgery,Lausanne University Hospital CHUV,University of Lausanne(UNIL),Lausanne CH‐1015,Switzerland;Division of Gastroenterology and Hepatology,UC Davis Medical Center and Sacramento VA Medical Center,Sacramento 95817,United States;Clinical Research Center,The Seventh Affiliated Hospital,Sun Yat‐sen University,Shenzhen 518107,China)

机构地区：[1]兰州大学第一临床医学院,兰州730030 [2]兰州大学第一医院普通外科,兰州730030 [3]浜松医学中心消化科,日本浜松432-8002 [4]詹姆斯库克大学医院血管外科,英国米德尔斯堡TS43BW [5]京都第二红十字医院消化科,日本京都602-8031 [6]朱拉隆功国王纪念医院胃肠内镜卓越中心,泰国曼谷10330 [7]雷根斯堡大学医学中心外科,德国雷根斯堡93053 [8]香港大学外科学系,中国香港999077 [9]洛桑大学医院内脏外科,瑞士洛桑CH-1015 [10]加州大学戴维斯分校医学中心和萨克拉门托退伍军人医学中心胃肠肝病科,美国萨克拉门托95817 [11]中山大学附属第七医院临床研究中心,深圳518107

出　　处：《中华消化外科杂志》2024年第7期989-1000,共12页Chinese Journal of Digestive Surgery

基　　金：国家重点研究发展项目(2022YFC2407406);甘肃省联合科研基金重大项目(23JRRA1488)。

摘　　要：胆道纤维化(BF)是病理性胆道损伤修复的结果,主要表现为胆管壁的增厚硬化和管腔的进行性狭窄,最终可能导致胆道梗阻、胆汁性肝硬化、肝衰竭、肝胆恶性肿瘤等严重不良结局。目前的研究将BF描述为某些胆管病的病理特征,对其病因、病理生理、分子机制和治疗缺乏系统总结。BF是胆道系统普遍存在但容易被忽略的疾病状态,可能通过病理性胆道损伤后的异常修复机制促进肝胆疾病的发生和进展,笔者结合国内外最新研究进展,综述BF的概念、临床表现、病因、发病机制和治疗策略,为临床医师提供参考。Biliary fibrosis(BF)is the result of pathological repair of bile tract injury,characterized by thickening and sclerosis of the bile duct wall and progressive stricture of the lumen,which may ultimately lead to serious adverse outcomes such as biliary obstruction,biliary cirrhosis,liver failure,and hepatobiliary malignancies.Current research describes BF as a pathological feature of certain bile tract diseases,lacking a systematic summary of its etiology,pathophysiology,molecular mechanisms,and treatment.BF is a common but easily neglected disease state in biliary system,which may promote the development and progression of hepatobiliary diseases through abnormal repair mechanism after pathological biliary tract injury.Based on the latest research progress from both domestic and international perspectives,the authors review the concept,clinical manifestation,etiology,pathogenesis,and therapeutic strategies of BF to provide a reference for clinical physicians.

关 键 词：胆道疾病 纤维化 胆管反应 病因 信号通路 治疗 

分 类 号：R575.7[医药卫生—消化系统]