难治性原发性胆汁性胆管炎的治疗新进展

倪萍; 凡小丽; 文茂瑶; 杨丽

doi:10.3969/j.issn.1001-5256.2017.11.040

难治性原发性胆汁性胆管炎的治疗新进展

DOI: 10.3969/j.issn.1001-5256.2017.11.040

四川大学华西医院消化内科

基金项目:

四川省科技厅应用基础项目(2017JY0071)；

详细信息

中图分类号: R575.7
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出版历程
- 收稿日期: 2017-06-26
- 出版日期: 2017-11-20

New advances in the treatment of refractory primary biliary cholangitis

Department of Gastroenterology, West China Hospital, Sichuan University

Research funding:

摘要

摘要: 原发性胆汁性胆管炎(PBC)是一种以小胆管损伤为特点的自身免疫性肝病。熊去氧胆酸(UDCA)是治疗本病的主要药物,但约40%的PBC患者对UDCA生化应答欠佳,预后较差。总结了难治性PBC患者的治疗新选择。2017年,奥贝胆酸已被欧洲肝病学会推荐作为UDCA应答不佳PBC的二线治疗药物。贝特类药物或布地奈德联合UDCA治疗难治性PBC的相关研究也取得了一定进展,但其疗效与安全性仍需大样本随机双盲对照试验进一步验证。单克隆抗体、改变胆汁酸生成或重吸收药物等尚处于实验阶段。目前,肝移植仍然是延长终末期PBC患者生存期的唯一治疗方法。
- 肝硬化,胆汁性 /
- 治疗 /
- 综述
Abstract: Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by small bile duct injury.Ursodeoxycholic acid (UDCA) is often used for the treatment of this disease;however, about 40% of PBC patients do not respond adequately to UDCA and often have poor prognosis.This article summarizes the new therapeutic options for such patients.In 2017, obeticholic acid has been recommended as the second-line therapeutic drug for PBC patients with suboptimal response to UDCA by European Association for the Study of the Liver.Some achievements have been made in the research on fibrates and budesonide administered alone or in combination for the treatment of refractory PBC, but their efficacy and safety need to be further confirmed by large-sample, double-blind, randomized controlled trials.Monoclonal antibody, change in the production of bile acid, and drug reabsorption are still under experiment.At present, liver transplantation remains the only therapeutic method for patients with end-stage PBC.
- liver cirrhosis, biliary /
- therapy /
- review

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