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糖皮质激素治疗药物性肝损伤的疗效及治疗策略:文献复习。

Glucocorticoid efficacy and treatment strategies for drug-induced liver injury: a literature review.

机构信息

State Key Laboratory of Cancer Biology, National Clinical Research Centre for Digestive Diseases, Xijing Hospital of Digestive Diseases, The Air Force Military Medical University, Xi'an, 710032, Shaanxi, China.

出版信息

Mol Biol Rep. 2024 Jul 31;51(1):879. doi: 10.1007/s11033-024-09806-w.

Abstract

Drug-induced liver injury (DILI) is an adverse reaction to drugs and their metabolites. The activation of adaptive immune and inflammatory responses plays an important role in the pathogenesis of DILI. Glucocorticoids (GCs) have powerful anti-inflammatory and immunosuppressive effects and have been used to treat a variety of immune-mediated liver diseases. Due to the important role of the immune system in DILI, GCs are widely used in the clinical treatment of DILI; however, whether they are beneficial to patients remains controversial. There is no uniform standard for the timing, dosage, and population selection of GCs, which mainly depend on the clinician's experience. Therefore, elucidating whether GCs are beneficial for patients with DILI is an urgent clinical problem. Our review summarizes the recent literature and discusses the clinical efficacy, applicable population, application timing, and efficacy of GCs in special types of DILI, providing a reference for the clinical application of GCs.

摘要

药物性肝损伤(DILI)是药物及其代谢物引起的不良反应。适应性免疫和炎症反应的激活在 DILI 的发病机制中起重要作用。糖皮质激素(GCs)具有强大的抗炎和免疫抑制作用,已被用于治疗多种免疫介导的肝脏疾病。由于免疫系统在 DILI 中的重要作用,GCs 在 DILI 的临床治疗中被广泛应用;然而,它们是否对患者有益仍存在争议。GCs 的应用时机、剂量和人群选择没有统一的标准,主要取决于临床医生的经验。因此,阐明 GCs 是否有益于 DILI 患者是一个紧迫的临床问题。我们的综述总结了最近的文献,并讨论了 GCs 在特殊类型 DILI 中的临床疗效、适用人群、应用时机和疗效,为 GCs 的临床应用提供参考。

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