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胆汁淤积性肝病的诊治现状及研究方向

于乐成 陈成伟

引用本文:
Citation:

胆汁淤积性肝病的诊治现状及研究方向

DOI: 10.3969/j.issn.1001-5256.2019.02.001
详细信息
  • 中图分类号: R575

Current status and research interests of the diagnosis and treatment of cholestatic liver disease

  • 摘要:

    胆汁淤积性肝病(CSLD)是指能够引起胆汁淤积的多种肝病的集合和统称,其病因复杂,发病机制有待深入阐明,尚缺乏足够有效的治疗手段。近十余年来对CSLD的多个方面有了较多新认识,为其精准诊治提供了更多层面和更为有效的抓手,同时也反映了许多问题依然悬而未决,亟需继续深入研究。本期重点号从6大方面介绍了有关CSLD的研究进展和存在问题:(1) CSLD的"上升"病理生理学模式;(2)胆汁淤积导致肝纤维化的机制及处置对策;(3)肠肝循环和肠道微生态与CSLD的关系;(4)药物性胆汁淤积的发病机制和诊疗问题;(5)肝衰竭时胆汁淤积的发生机制及处置对策;(6)胆汁淤积性肝病的治疗靶点和药物研发进展等。

     

  • [1]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 treatment of cholestasis liver diseases[J].J Clin Hepatol, 2015, 31 (12) :1989-1999. (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.胆汁淤积性肝病诊断和治疗共识[J].临床肝胆病杂志, 2015, 31 (12) :1989-1999.
    [2]YU YC, MAO YM, CHEN CW, et al.CSH guideline for the diagnosis and treatment of drug-induced liver injury[J].Hepatol Int, 2017, 11 (3) :221-241.
    [3]National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association;Fatty Liver Expert Committee, Chinese Medical Doctor Association.Guidelines of prevention and treatment for alcoholic liver disease:A 2018 update[J].J Clin Hepatol, 2018, 34 (5) :939-946. (in Chinese) 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会.酒精性肝病防治指南 (2018年更新版) [J].临床肝胆病杂志, 2018, 34 (5) :939-946.
    [4]European Association for the Study of the Liver.EASL clinical practice guidelines:Management of alcohol-related liver disease[J].J Hepatol, 2018, 69 (1) :154-181.
    [5]European Association for the Study of the Liver.EASL clinical practice guidelines on hepatitis E virus infection[J].J Hepatol, 2018, 68 (6) :1256-1271.
    [6]HOU JL, WANG GQ, WANG FS, et al.Guideline of prevention and treatment for chronic hepatitis B (2015 update) [J].JClin Transl Hepatol, 2017, 5 (4) :297-318.
    [7]HIRSCHFIELD GM, DYSON JK, ALEXANDER GJM, et al.The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines[J].Gut, 2018, 67 (9) :1568-1594.
    [8]ISAYAMA H, TAZUMA S, KOKUDO N, et al.Clinical guidelines for primary sclerosing cholangitis 2017[J].J Gastroenterol, 2018, 53 (9) :1006-1034.
    [9]POLLHEIMER MJ, FICKERT P, STIEGER B.Chronic cholestatic liver diseases:Clues from histopathology for pathogenesis[J].Mol Aspects Med, 2014, 37:35-56.
    [10]STICOVA E, JIRSA M, PAWOWSKA J.New Insights in genetic cholestasis:From molecular mechanisms to clinical implications[J].Can J Gastroenterol Hepatol, 2018, 2018:2313675.
    [11]JANSEN PL, GHALLAB A, VARTAK N, et al.The ascending pathophysiology of cholestatic liver disease[J].Hepatology, 2017, 65 (2) :722-738.
    [12]GONZLEZ-REGUEIRO JA, MORENO-CASTAEDA L, URIBEM, et al.The role of bile acids in glucose metabolism and their relation with diabetes[J].Ann Hepatol, 2017, 16 (Suppl 1) :16-21.
    [13]TRAUNER M, CLAUDEL T, FICKERT P, et al.Bile acids as regulators of hepatic lipid and glucose metabolism[J].Dig Dis, 2010, 28 (1) :220-224.
    [14]WELLS RG, SCHWABE RF.Origin and function of myofibroblasts in the liver[J].Semin Liver Dis, 2015, 35 (2) :97-106.
    [15] LI Y, TANG R, LEUNG PSC, et al.Bile acids and intestinal microbiota in autoimmune cholestatic liver diseases[J].Autoimmun Rev, 2017, 16 (9) :885-896.
    [16]LIU HX, KEANE R, SHENG L, et al.Implications of microbiota and bile acid in liver injury and regeneration[J].J Hepatol, 2015, 63 (6) :1502-1510.
    [17]RAMREZ-PREZ O, CRUZ-RAMN V, CHINCHILLA-LPEZ P, et al.The role of the gut microbiota in bile acid metabolism[J].Ann Hepatol, 2017, 16 (Suppl 1) :s15-s20.
    [18]DI CIAULA A, GARRUTI G, LUNARDI BACCETTO R, et al.Bile acid physiology[J].Ann Hepatol, 2017, 16 (Suppl 1) :s4-s14.
    [19]NIE YF, HU J, YAN XH.Cross-talk between bile acids and intestinal microbiota in host metabolism and health[J].J Zhejiang Univ Sci B, 2015, 16 (6) :436-446.
    [20] TILG H, CANI PD, MAYER EA.Gut microbiome and liver diseases[J].Gut, 2016, 65 (12) :2035-2044.
    [21]MATSUBARA T, LI F, GONZALEZ FJ.FXR signaling in the enterohepatic system[J].Mol Cell Endocrinol, 2013, 368 (1-2) :17-29.
    [22]TABIBIAN JH, TALWALKAR JA, LINDOR KD.Role of the microbiota and antibiotics in primary sclerosing cholangitis[J].Biomed Res Int, 2013, 2013:389537.
    [23] DANAN G, TESCHKE R.RUCAM in drug and herb induced liver injury:The update[J].Int J Mol Sci, 2016, 17 (1) :14.
    [24]Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association;Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association.Guideline for diagnosis and treatment of liver failure[J].J Clin Hepatol, 2019, 35 (1) :38-44. (in Chinese) 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南 (2018年版) [J].临床肝胆病杂志, 2019, 35 (1) :38-44.
    [25]HERNAEZ R, SOLE, MOREAU R, et al.Acute-on-chronic liver failure:An update[J].Gut, 2017, 66 (3) :541-553.
    [26]European Association for the Study of the Liver.EASL clinical practical guidelines on the management of acute (fulminant) liver failure[J].J Hepatol, 2017, 66 (5) :1047-1081.
    [27]European Association for the Study of the Liver.EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J].J Hepatol, 2018, 69 (2) :406-460.
    [28]OLSSON R, BOBERG KM, de MUCKADELL OS, et al.Highdose ursodeoxycholic acid in primary sclerosing cholangitis:A5-year multicenter, randomized, controlled study[J].Gastroenterology, 2005, 129 (5) :1464-1472.
    [29] 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.
    [30]TRAUNER M, FUCHS CD, HALILBASIC E, et al.New therapeutic concepts in bile acid transport and signaling for management of cholestasis[J].Hepatology, 2017, 65 (4) :1393-1404.
    [31]KOWDLEY KV, LUKETIC V, CHAPMAN R, et al.A randomized trial of obeticholic acid monotherapy in patients with primary biliary cholangitis[J].Hepatology, 2018, 67 (5) :1890-1902.
    [32]CHEUNG AC, LAZARIDIS KN, LARUSSO NF, et al.Emerging pharmacologic therapies for primary sclerosing cholangitis[J].Curr Opin Gastroenterol, 2017, 33 (3) :149-157.
    [33]GOLDSTEIN J, LEVY C.Novel and emerging therapies for cholestatic liver diseases[J].Liver Int, 2018, 38 (9) :1520-1535.
    [34]de VRIES E, BEUERS U.Management of cholestatic disease in 2017[J].Liver Int, 2017, 37 (Suppl 1) :123-129.
    [35] CORPECHOT C, CHAZOUILLRES O, ROUSSEAU A, et al.A placebo-controlled trial of bezafibrate in primary biliary cholangitis[J].N Engl J Med, 2018, 378 (23) :2171-2181.
    [36]JONES D, BOUDES PF, SWAIN MG, et al.Seladelpar (MBX-8025) , a selective PPAR-δagonist, in patients with primary biliary cholangitis with an inadequate response to ursodeoxycholic acid:A double-blind, randomised, placebo-controlled, phase 2, proof-of-concept study[J].Lancet Gastroenterol Hepatol, 2017, 2 (10) :716-726.
    [37]BEUERS U, TRAUNER M, JANSEN P, et al.New paradigms in the treatment of hepatic cholestasis:From UDCA to FXR, PXRand beyond[J].J Hepatol, 2015, 62 (Suppl 1) :s25-s37.
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  • 出版日期:  2019-02-20
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