Sivakumar Tarika, Kowdley Kris V
Liver Institute Northwest Seattle, Seattle, WA, USA.
Hepat Med. 2021 Aug 28;13:83-92. doi: 10.2147/HMER.S256692. eCollection 2021.
Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, is a chronic cholestatic immune-mediated liver disease characterized by injury to intrahepatic bile ducts that may ultimately progress to cirrhosis and liver failure and result in the need for liver transplant or death without treatment. Ursodeoxycholic acid (UDCA) and obeticholic acid (OCA) are approved therapies for PBC and are associated with a reduced risk of progression of disease, although patients may continue to experience significant symptoms of pruritus and fatigue independent of liver disease. The two most commonly reported symptoms among patients with PBC are fatigue and pruritus which may be debilitating, and negatively impact physical, mental, emotional, and social wellbeing. Intense symptom burden has been associated with depressive symptoms, cognitive defects, poor sleep schedules, and social isolation. This literature review explores the presence of anxiety and depressive symptoms in chronic liver disease, the impact of symptom burden on patients' wellbeing, and available pharmaceutical and natural therapies.
原发性胆汁性胆管炎（PBC），以前称为原发性胆汁性肝硬化，是一种慢性胆汁淤积性免疫介导的肝脏疾病，其特征是肝内胆管受损，最终可能发展为肝硬化和肝衰竭，若不治疗则可能需要进行肝移植或导致死亡。熊去氧胆酸（UDCA）和奥贝胆酸（OCA）是已获批用于治疗PBC的药物，与疾病进展风险降低相关，尽管患者可能会持续出现严重的瘙痒和疲劳症状，且这些症状与肝脏疾病无关。PBC患者中最常报告的两种症状是疲劳和瘙痒，这两种症状可能使人虚弱，并对身体、心理、情感和社会福祉产生负面影响。严重的症状负担与抑郁症状、认知缺陷、不良的睡眠习惯和社会隔离有关。这篇文献综述探讨了慢性肝病中焦虑和抑郁症状的存在情况、症状负担对患者福祉的影响以及现有的药物和天然疗法。
