Bayer E M, Schramm C, Kanzler S, Lohse A W
I. Medizinische Klinik und Poliklinik Johannes-Gutenberg-Universität Mainz, Germany.
Z Gastroenterol. 2004 Jan;42(1):19-30. doi: 10.1055/s-2004-812686.
Autoimmune Hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and overlap syndromes of these three disease entities are regarded as autoimmune liver diseases. These conditions are important differential diagnoses of elevated liver function tests as about 10 % of liver transplantations in Europe and North America are for these indications. The diagnosis is often difficult but can be facilitated by sequential measurement of relevant autoantibodies, exclusion of other liver disease, ultrasound, ERCP and liver histology. In AIH immunosuppressive therapy has been shown to prevent or stop the development of cirrhosis and improve the prognosis of the patients decisively. In other autoimmune liver diseases this evidence is missing making individual therapeutic decisions necessary. Ursodesoxycholic acid (UDCA) seems to slow disease progression in particular in early stages of PBC.
自身免疫性肝炎(AIH)、原发性胆汁性肝硬化(PBC)、原发性硬化性胆管炎(PSC)以及这三种疾病实体的重叠综合征被视为自身免疫性肝病。这些病症是肝功能检查结果升高的重要鉴别诊断,因为在欧洲和北美,约10%的肝移植是基于这些指征。诊断通常很困难,但通过依次检测相关自身抗体、排除其他肝病、超声检查、内镜逆行胰胆管造影(ERCP)和肝组织学检查可辅助诊断。在AIH中,免疫抑制治疗已被证明可预防或阻止肝硬化的发展,并决定性地改善患者的预后。在其他自身免疫性肝病中,缺乏这方面的证据,因此需要做出个体化的治疗决策。熊去氧胆酸(UDCA)似乎能减缓疾病进展,尤其是在PBC的早期阶段。