Perdigoto R, Wiesner R H
Division of Hepatology and Gastroenterology, Mayo Clinic, Rochester, Minnesota.
Gastroenterology. 1992 Apr;102(4 Pt 1):1389-91.
Three patients with symptomatic, noncirrhotic primary biliary cirrhosis who had no evidence of esophageal varices on esophagogastroduodenoscopy and who were treated with ursodeoxycholic acid, 15 mg.kg-1.day-1, for a period of 1-2 years are reported. Initially, all three patients showed improvement in symptoms of fatigue and pruritus, and there was marked improvement or normalization in serum levels of bilirubin, alkaline phosphatase, and alanine aminotransferase. However, after 1-2 years, all three patients progressed histologically to cirrhosis on follow-up liver biopsy, and all had esophageal variceal bleeding documented by esophagogastroduodenoscopy. These three patients represent examples of ursodeoxycholic acid treatment failure despite improvements in symptoms and biochemical liver test results.
报告了3例有症状的非肝硬化性原发性胆汁性肝硬化患者，这些患者在食管胃十二指肠镜检查中未发现食管静脉曲张证据，并接受熊去氧胆酸治疗，剂量为15mg·kg-1·天-1，持续1至2年。最初，所有3例患者的疲劳和瘙痒症状均有改善，血清胆红素、碱性磷酸酶和丙氨酸转氨酶水平显著改善或恢复正常。然而，1至2年后，所有3例患者在随访肝活检中组织学进展为肝硬化，且所有患者均经食管胃十二指肠镜检查证实有食管静脉曲张出血。这3例患者代表了尽管症状和肝脏生化检查结果有所改善，但熊去氧胆酸治疗失败的病例。
