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原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征的诊治

杨宁 刘雁声 韩英

引用本文:
Citation:

原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征的诊治

DOI: 10.3969/j.issn.1001-5256.2020.03.051
基金项目: 

国家自然科学基金项目(81770569,81870421); 

详细信息
  • 中图分类号: R575.7

Diagnosis and treatment of primary biliary cholangitis-autoimmune hepatitis overlap syndrome

Research funding: 

 

  • 摘要: 自身免疫性肝病(AILD)包括原发性胆汁性胆管炎(PBC)、自身免疫性肝炎(AIH)、原发性硬化性胆管炎(PSC)。患者可在初诊时或随访的过程中出现2种AILD的特征,通常将这种情况称为"重叠综合征",其中以PBC重叠AIH最为常见。与单纯PBC或AIH相比,PBC-AIH重叠综合征门静脉高压、消化道出血、腹水、死亡及肝移植发生率明显升高,病情进展也更迅速,因此,其早诊早治显得尤为重要。对近年PBC-AIH重叠综合征的诊治进展进行综述。

     

  • [1] TRIVEDI PJ,HIRSCHFIELD GM. Review article:Overlap syndromes and autoimmune liver disease[J]. Aliment Pharmacol Ther,2012,36(6):517-533.
    [2] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Infectious Diseases,Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. J Clin Hepatol,2016,32(1):9-22.(in Chinese)中华医学会肝病学分会,中华医学会消化病学分会,中华医学会感染病学分会.自身免疫性肝炎诊断和治疗共识(2015)[J].临床肝胆病杂志,2016,32(1):9-22.
    [3] BOBERG KM,CHAPMAN RW,HIRSCHFIELD GM,et al. Overlap syndromes:The International Autoimmune Hepatitis Group(IAIHG)position statement on a controversial issue[J]. J Hepatol,2010,54(2):374-385.
    [4] JOSHI S. Primary biliary cirrhosis with additional features of autoimmune hepatitis:Response to therapy with ursodeoxycholic acid[J]. Hepatology,2002,35(2):409-413.
    [5] WEILER NC,LOHSE AW. Variant syndromes of autoimmune liver diseases:Classification, diagnosis and management[J]. Dig Dis,2016,34(4):334-339.
    [6] LINDOR KD,GERSHWIN ME,POUPON R,et al. Primary biliary cirrhosis[J]. Hepatology,2009,50(1):291-308.
    [7] CHAZOUILLÈRES O,WENDUM D,SERFATY L,et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:Clinical features and response to therapy[J]. Hepatology,1998,28(2):296-301.
    [8] ALVAREZ F,BERG PA,BIANCHI FB,et al. International Autoimmune Hepatitis Group Report:Review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol,1999,31(5):929-938.
    [9] HENNES EM,ZENIYA M,CZAJA AJ,et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology,2008,48(1):169-176.
    [10] European Association for the Study of the Liver. EASL clinical practice guidelines:The diagnosis and management of patients with primary biliary cholangitis[J]. J Hepatol,2017,67(1):145-172.
    [11] EFE C,OZASLAN E,HEURGUE-BERLOT A,et al. Sequential presentation of primary biliary cirrhosis and autoimmune hepatitis[J]. Eur J Gastroenterol Hepatol,2014,26(5):532-537.
    [12] WANG L,HAN Y. An excerpt of primary biliary cholangitis:2018 practice guidance from the American Association for the Study of Liver Diseases[J]. J Clin Hepatol,2018,34(11):2300-2304.(in Chinese)王璐,韩英.《2018年美国肝病学会原发性胆汁性胆管炎实践指导》摘译[J].临床肝胆病杂志,2018,34(11):2300-2304.
    [13] HIMOTO T,YONEYAMA H,KUROKOHCHI K,et al. Clinical significance of autoantibodies to p53 protein in patients with autoimmune liver diseases[J]. Can J Gastroenterol,2012,26(3):125-129.
    [14] EYRAUD V,CHAZOUILLERES O,BALLOT E,et al. Significance of antibodies to soluble liver antigen/liver pancreas:A large French study[J]. Liver Int,2009,29(6):857-864.
    [15] NGUYEN HH,SHAHEEN AA,BAEZA N,et al. Evaluation of classical and novel autoantibodies for the diagnosis of primary biliary cholangitis-autoimmune hepatitis overlap syndrome(PBC-AIH OS)[J]. PLo S One,2018,13(3):e193960.
    [16] SCHULZ L,SEBODE M,WEIDEMANN SA,et al. Variant syndromes of primary biliary cholangitis[J]. Best Pract Res Clin Gastroenterol,2018,34-35:55-61.
    [17] WANG QX,MA X. Advances in diagnosis and treatment of autoimmune liver diseases overlap syndrome[J]. Chin J Gastroenterol,2018,23(5):283-286.(in Chinese)王绮夏,马雄.自身免疫性肝病重叠综合征诊治进展[J].胃肠病学,2018,23(5):283-286.
    [18] COSS AE,GRANADOS J,URIBE M,et al. Does HLA-DR7 differentiate the overlap syndrome of auto-immune hepatitis-primary biliary cirrhosis(AIH-PBC)from those with auto-immune hepatitis type 1?[J]. Ann Hepatol,2011,10(1):28-32.
    [19] HIRSCHFIELD GM,KARLSEN TH. Genetic risks link autoimmune hepatitis to other autoimmune liver disease[J]. Gastroenterology,2014,147(2):270-273.
    [20] MALIK N,VENKATESH SK. Imaging of autoimmune hepatitis and overlap syndromes[J]. Abdom Radiol,2017,42(1):19-27.
    [21] WU H,SHENG L,WANG Q,et al. Performance of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome[J]. World J Gastroenterol,2018,24(6):737-743.
    [22] CHRISTENSEN E,CROWE J,DONIACH D,et al. Clinical pattern and course of disease in primary biliary cirrhosis based on an analysis of 236 patients[J]. Gastroenterology,1980,78(2):236-246.
    [23] KUIPER EM,ZONDERVAN PE,van BUUREN HR. Paris criteria are effective in diagnosis of primary biliary cirrhosis and autoimmune hepatitis overlap syndrome[J]. Clin Gastroenterol Hepatol,2010,8(6):530-534.
    [24] ZHANG W,DE D,MOHAMMED KA,et al. New scoring classification for primary biliary cholangitis-autoimmune hepatitis overlap syndrome[J]. Hepatol Commun,2018,2(3):245-253.
    [25] LIU F,PAN ZG,YE J,et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:Simplified criteria may be effective in the diagnosis in Chinese patients[J]. J Dig Dis,2014,15(12):660-668.
    [26] NEUHAUSER M,BJORNSSON E,TREEPRASERTSUK S,et al.Autoimmune hepatitis-PBC overlap syndrome:A simplifed scoring system may assist in the diagnosis[J]. Am J Gastroenterol,2010,105(2):345-353.
    [27] SILVEIRA MG,TALWALKAR JA,ANGULO P,et al. Overlap of autoimmune hepatitis and primary biliary cirrhosis:Long-term outcomes[J]. Am J Gastroenterol,2007,102(6):1244-1250.
    [28] YANG F,WANG Q,WANG Z,et al. The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis[J]. Clin Rev Allergy Immunol,2016,50(1):114-123.
    [29] PARK Y,CHO Y,CHO EJ,et al. Retrospective analysis of autoimmune hepatitis-primary biliary cirrhosis overlap syndrome in Korea:characteristics,treatments,and outcomes[J]. Clin Mol Hepatol,2015,21(2):150.
    [30] ZHANG H,YANG J,ZHU R,et al. Combination therapy of ursodeoxycholic acid and budesonide for PBC-AIH overlap syndrome:A meta-analysis[J]. Drug Des Devel Ther,2015,9:567-574.
    [31] OZASLAN E,EFE C,HEURGUE-BERLOT A,et al. Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis[J]. Clin Gastroenterol Hepatol,2014,12(5):863-869.
    [32] WANG Q,SELMI C,ZHOU X,et al. Epigenetic considerations and the clinical reevaluation of the overlap syndrome between primary biliary cirrhosis and autoimmune hepatitis[J]. J Autoimmun,2013,41:140-145.
    [33] European Association for the Study of the Liver. EASL clinical practice guidelines:Autoimmune hepatitis[J]. J Hepatol,2015,63(4):971-1004.
    [34] CHAZOUILLÈRES O,WENDUM D,SERFATY L,et al. Long term outcome and response to therapy of primary biliary cirrhosis—autoimmune hepatitis overlap syndrome[J]. J Hepatol,2006,44(2):400-406.
    [35] BAVEN-PRONK AM,COENRAAD MJ,VAN BUUREN HR,et al.The role of mycophenolate mofetil in the management of autoimmune hepatitis and overlap syndromes[J]. Aliment Pharmacol Ther,2011,34(3):335-343.
    [36] BHANJI RA,MASON AL,MONTANO-LOZA AJ. Liver transplantation for overlap syndrome of autoimmune liver diseases[J]. J Hepatol,2012,56:s89-s90.
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  • 收稿日期:  2019-11-07
  • 出版日期:  2020-03-20
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