Honeckman Adam
Mobile Veterinary Diagnostics, Casselberry, FL 32707, USA.
Clin Tech Small Anim Pract. 2003 Nov;18(4):239-44. doi: 10.1016/S1096-2867(03)00050-1.
Chronic hepatitis is a common disorder in dogs seen by general practitioners. Several new drugs have been marketed for treating this disease. Unfortunately, there are few controlled studies that examine the efficacy of these medications for the treatment of canine chronic hepatitis. A rational therapeutic approach can be implemented based on histopathologic findings of a liver biopsy. A liver biopsy is essential for establishing a definitive diagnosis and guiding the optimal therapy. The biopsy allows characterizing the inflammatory process, quantitating hepatic copper concentrations, and determining if fibrosis is present. Copper associated hepatopathy is treated with zinc and copper chelators. Idiopathic chronic hepatitis is thought to be immune mediated. The treatment of idiopathic chronic hepatitis consists of controlling inflammation (prednisone, azathioprine), reversing fibrosis (colchicine), and protecting against oxidant damage (vitamin E, ursodeoxycholic acid, S-adenosylmethionine). The prognosis for chronic hepatitis is quite variable. Dogs with end-stage disease have a poor prognosis, while dogs diagnosed earlier can have a mean survival of years. Early diagnosis and intervention are key to the successful treatment of dogs with chronic hepatitis.
慢性肝炎是全科医生常见的犬类疾病。有几种新药已上市用于治疗这种疾病。不幸的是，很少有对照研究来检验这些药物治疗犬慢性肝炎的疗效。基于肝活检的组织病理学结果可以实施合理的治疗方法。肝活检对于确立明确诊断和指导最佳治疗至关重要。活检有助于对炎症过程进行特征描述、定量肝铜浓度以及确定是否存在纤维化。与铜相关的肝病用锌和铜螯合剂治疗。特发性慢性肝炎被认为是免疫介导的。特发性慢性肝炎的治疗包括控制炎症（泼尼松、硫唑嘌呤）、逆转纤维化（秋水仙碱）以及预防氧化损伤（维生素E、熊去氧胆酸、S-腺苷甲硫氨酸）。慢性肝炎的预后差异很大。终末期疾病的犬预后不良，而早期诊断的犬平均生存期可达数年。早期诊断和干预是成功治疗犬慢性肝炎的关键。
