慢性胆汁淤积性肝病中的瘙痒。

Pruritus in chronic cholestatic liver disease.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, University of Pennsylvania, Philadelphia, USA.

出版信息

Clin Liver Dis. 2012 May;16(2):331-46. doi: 10.1016/j.cld.2012.03.010.

DOI:10.1016/j.cld.2012.03.010

Abstract

Pruritus is a troublesome complication in patients with cholestatic liver disease. Several links to its pathogenesis have been proposed, including the role of bile acids, endogenous opioid and serotonins, and lysophosphatidic acid. The management of pruritus in cholestasis is challenging. Medical treatment of the underlying cholestatic condition may provide benefit. Extracorporeal albumin dialysis can be pursued for those who have a poor quality of life and failed the various therapeutic interventions, while awaiting liver transplantation. Experimental interventions, and the management of pruritus in certain conditions such as intrahepatic cholestasis of pregnancy and benign recurrent intrahepatic cholestasis, are also briefly reviewed.

摘要

瘙痒是胆汁淤积性肝病患者的一种麻烦的并发症。其发病机制有几个相关环节，包括胆汁酸、内源性阿片类物质和 5-羟色胺及溶血磷脂酸的作用。胆汁淤积性瘙痒的治疗具有挑战性。治疗潜在的胆汁淤积性疾病可能有益。对于生活质量差且各种治疗干预措施失败的患者，可以进行体外白蛋白透析，同时等待肝移植。本文还简要回顾了一些实验性干预措施，以及妊娠肝内胆汁淤积症和良性复发性肝内胆汁淤积症等特定情况下瘙痒的管理。