Al-Chalabi Thawab, Heneghan Michael A
Am J Gastroenterol. 2007 May;102(5):1013-5. doi: 10.1111/j.1572-0241.2007.01147.x.
The goals of therapy in autoimmune hepatitis (AIH) are to dampen inflammation within the liver, with the aim of inducing remission, improving symptoms, and prolonging survival. Ideally, treatment could be stopped once remission has been achieved. However, cessation of therapy may be complicated by relapse in substantial numbers of patients and although as many as 30% of patients could remain in remission, it is impossible to predict which patients can stop therapy safely and avoid unnecessary prolongation of immunosuppression therapy. A retrospective analysis of data from a large single centre has assessed parameters that could predict maintenance of remission following withdrawal of therapy. Importantly, it has been shown that therapy should not be withdrawn in any patient who has not achieved complete normalization of biochemistry in the presence of normal histology, nonspecific portal hepatitis, or inactive cirrhosis. The results illustrate the difficulties in relation to defining remission and relapse in patients with AIH and highlight the need for consistency in terminology.
自身免疫性肝炎（AIH）的治疗目标是减轻肝脏内的炎症，以诱导缓解、改善症状并延长生存期。理想情况下，一旦实现缓解即可停止治疗。然而，大量患者可能会因复发而使治疗中断复杂化，尽管多达30%的患者可能保持缓解状态，但无法预测哪些患者能够安全地停止治疗并避免不必要地延长免疫抑制治疗。一项来自大型单中心的数据回顾性分析评估了可预测治疗停药后缓解维持情况的参数。重要的是，研究表明，在组织学正常、非特异性门脉性肝炎或静止性肝硬化的情况下，任何生化指标未完全正常化的患者都不应停药。结果表明了在定义AIH患者的缓解和复发方面存在困难，并突出了术语一致性的必要性。
