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原发性胆汁性胆管炎肝移植术后预后研究现状与挑战

陈林 刘宁 金晶兰 蔡艳俊 许芳 牛俊奇 李婉玉

引用本文:
Citation:

原发性胆汁性胆管炎肝移植术后预后研究现状与挑战

DOI: 10.3969/j.issn.1001-5256.2021.04.050
基金项目: 

2018年吉林省科技发展计划项目 (20180520116JH)

2017年天晴肝病研究基金 (TQGB20180160)

2017年吉林大学第一医院交叉学科创新项目 (JDYYJC006)

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:陈林、刘宁、李婉玉负责课题设计,资料分析,撰写论文;金晶兰、许芳参与收集数据,修改论文;李婉玉、蔡艳俊、牛俊奇负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    作者简介:

    陈林(1995—),女,主要从事原发性胆汁性胆管炎诊断和治疗方面的研究

    通信作者:

    李婉玉,liwanyu2006@163.com

  • 中图分类号: R575.22

Research status and challenges in the prognosis of primary biliary cholangitis after liver transplantation

  • 摘要: 原发性胆汁性胆管炎(PBC)是一种病因尚不明确的慢性胆汁淤积性肝病。熊去氧胆酸、奥贝胆酸等药物治疗不佳的患者最终发展为肝硬化,甚至肝衰竭。目前,肝移植是治疗PBC的唯一有效手段。主要阐述了PBC患者进行肝移植的概况、肝移植术后生存期、并发症、PBC复发以及肝移植治疗前景及挑战,为PBC移植术后的临床转归及治疗提供参考。

     

  • 表  1  不同病因的肝病患者进行肝移植的术后生存率

    病因 1年(%) 3年(%) 5年(%) 10年(%)
    PBC[14-15] 93~94 90~91 82~86 71.2
    原发性硬化性胆管炎[16] 86 79 76 66
    自身免疫性肝炎[17] 88 84 79 68
    乙型肝炎[18] 86 73 59
    丙型肝炎[19] 87 79 72
    酒精性肝病[20] 86 73 59
    非酒精性脂肪性肝病[17] 89 83 77 63
    原发性肝癌[21] 85 75 67
    下载: 导出CSV

    表  2  不同中心PBC患者进行肝移植后复发情况

    作者 年份 地区 例数 定期肝活检 随访时间(年) 5/10年生存率(%) 复发[例(%)] 复发时间(年)
    Campsen等[32] 2009 美国 70 7.8(0.3~17) 72/54 18(26) 4.8(0.4~13)
    Manousou等[33] 2010 英国 103 9(1~20) -/- 36(35) 3.7(1~17)
    Montano-Loza等[34] 2010 加拿大 108 7.3(0.2~19) 86/76 28(26) 5.8(0.5~16)
    Jacob等[35] 2010 德国 121 10(0.4~19) 87/84 18(15) 5(3~10)
    Kaneko等[36] 2012 日本 81 6.2(0.1~13.4) 80/- 2(3) -
    Bosch等[37] 2015 法国 90 11.7±5.5 98/94 48(53) 6.4(1~21.6)
    Egawa等[15] 2016 日本 444 7.5(0.003~18.8) 76.6/71.2 65(14.6) 5.1
    下载: 导出CSV
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  • 收稿日期:  2020-09-22
  • 录用日期:  2020-10-09
  • 出版日期:  2021-04-20
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