Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
World J Gastroenterol. 2019 Apr 21;25(15):1817-1827. doi: 10.3748/wjg.v25.i15.1817.
The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore, management of the various symptoms of liver cirrhosis is essential, and aging-related parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.
器官功能的老化导致对疾病进展的敏感性,需要仔细考虑治疗方法。随着人口老龄化的增加,为非常高龄人群提供医疗的机会迅速增加,因此,了解细胞功能、器官大小和功能的各种生理变化对于治疗方案的决策至关重要。在老年人中常见的各种慢性疾病中,我们重点关注肝硬化,因为尽管针对许多肝脏疾病(包括直接作用抗病毒药物治疗丙型肝炎病毒、核苷类似物治疗乙型肝炎、和自身免疫性肝炎的皮质类固醇)有特定的治疗选择,但目前尚无标准疗法可治疗肝硬化,这是这些肝脏疾病的终末期。因此,管理肝硬化的各种症状至关重要,在治疗策略和现有药物剂量的决策中必须考虑与衰老相关的参数。在这个小综述中,我们总结了管理肝硬化各种症状的治疗选择,仔细考虑了与衰老相关的各种器官的生理变化。