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欧洲与我国最新原发性硬化性胆管炎临床实践指南的比较
DOI: 10.3969/j.issn.1001-5256.2023.01.007
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：李小科、叶永安对确定论文设计有关键性的贡献；孙鑫起草了论文；张婷玉、姚俞昊、郭紫薇、张嘉鑫参与了论文撰写；李小科对论文的主要内容进行了修订。
Highlights of the EASL clinical practice guidelines on sclerosing cholangitis versus the latest Chinese guideline
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摘要: 2022年欧洲肝病学会(EASL)发布了《欧洲肝病学会硬化性胆管炎临床实践指南》。本文结合《2017年欧洲胃肠道内窥镜学会和欧洲肝病学会临床指南：内窥镜检查在原发性硬化性胆管炎中的作用》提炼更新要点，并着重与2021年中华医学会肝病学分会《原发性硬化性胆管炎诊断及治疗指南(2021)》中的相应内容进行比较，归纳了新版指南在诊断、治疗、监测和特殊人群管理等方面的更新意见，分析了更新推荐意见的依据及其对原发性硬化性胆管炎(PSC)临床实践优化的指导意义。对比分析表明，新版指南在诊治和随访的总体观点与我国指南相仿，在包括熊去氧胆酸推荐剂量及长期随访方案等技术细节上值得借鉴。但该病作为慢性难治性疾病，现有指南推荐药物仍难以阻断、逆转疾病进展，而免疫疗法、终末期并发症筛查方案缺乏共识，是值得关注的研究方向。Abstract: In 2022, the European Association for the Study of the Liver issued Clinical practice guidelines on sclerosing cholangitis. With reference to the 2017 edition of Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline (2017) and in comparison to the corresponding contents in Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021) issued by Chinese Society of Hepatology, Chinese Medical Association, in 2021, this article summarizes the updates in diagnosis, treatment, monitoring, and management of special populations and analyzes the basis for updated recommendations and their guiding significance in optimizing the clinical management of primary sclerosing cholangitis (PSC). The comparative analysis shows that the new version of the guidelines is similar to the Chinese guidelines in terms of diagnosis, treatment, and follow-up, and it is worth learning from the technical details such as the recommended dose of ursodeoxycholic acid and long-term follow-up plan. Since PSC is a chronic refractory disease, the drugs recommended by current guidelines cannot delay or reverse disease progression, and there is still a lack of consensus statements on immunotherapy and screening protocols for end-stage complications, which might be the directions for further research.
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Key words:
- Primary Sclerosing Cholangitis /
- Diagnosis /
- Therapeutics /
- Surveillance /
- Practice Guidelines as Topic
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