Brodanová M
I. interní klinika 1. lékarské fakulty UK a VFN, Praha.
Vnitr Lek. 2003 Aug;49(8):689-95.
Cholestasis is a condition, where the bile flow into the intestine is defective. The causes may be extrahepatic (in large biliary ducts) or intrahepatic (at the level of hepatocytes or minor biliary ducts). The lack of bile in the intestine results in serious consequences, mainly malabsorption, malnutrition and skeletal changes. The compounds, which are normally excreted in the bile, accumulate and liver biliary cirrhosis ensues. Cholestatis is characterized by a typical laboratory picture, outlined in publications, which serves for differentiation of individual forms of cholestasis. There are various causes of cholestasis, listed in the survey. Extrahepatic cholestasis must be treated as early as possible (by endoscopy or surgery). The highest attention is devoted mainly to chronic intrahepatic cholestatis: primary biliary cirrhosis. It affects mainly women at middle age and is most frequently considered as an autoimmune disease. A survey of present therapeutic possibilities for cholestasis is given. Ursodeoxycholic acid became the main therapeutic drug. It must be administered as early as possible and for long period of time in all cases.
胆汁淤积是一种胆汁流入肠道出现障碍的病症。其病因可能是肝外性的(发生在大胆管)或肝内性的(发生在肝细胞或小胆管水平)。肠道内胆汁缺乏会导致严重后果,主要是吸收不良、营养不良和骨骼变化。通常经胆汁排泄的化合物会蓄积,继而引发肝胆汁性肝硬化。胆汁淤积具有典型的实验室检查结果,在相关出版物中有概述,可用于区分不同类型的胆汁淤积。调查列出了胆汁淤积的各种病因。肝外胆汁淤积必须尽早治疗(通过内镜检查或手术)。目前最受关注的主要是慢性肝内胆汁淤积:原发性胆汁性肝硬化。它主要影响中年女性,最常被视为一种自身免疫性疾病。本文给出了当前胆汁淤积治疗可能性的综述。熊去氧胆酸已成为主要治疗药物。在所有病例中都必须尽早且长期给药。