Sherlock S
Minerva Med. 1978 Aug 18;69(38):2605-9.
Immunosuppressive treatment with prednisolone and/or azathioprine has been assessed in three chronic liver diseases with immunological features, namely chronic active hepatitis, cryptogenic cirrhosis and primary biliary cirrhosis. In chronic active hepatitis, controlled prospective clinical trials have shown clinical, biochemical and hepatic histological improvement when prednisolone with or without azathioprine is employed. Azathioprine alone has no advantage over placebo tablets. Cirrhosis is probably not prevented. Selection of patients for treatment, the response and therapeutic regimes are discussed. Patients with hepatitis B surface antigen positive chronic active hepatitis have a worse therapeutic response than those patients with chronic active hepatitis who are HBsAg negative. In primary biliary cirrhosis, corticosteroid treatment is contra-indicated on account of bone thinning. Azathioprine has been used in controlled clinical trials and is of only marginal benefit.
已对泼尼松龙和/或硫唑嘌呤的免疫抑制治疗在三种具有免疫特征的慢性肝病中进行了评估，即慢性活动性肝炎、隐源性肝硬化和原发性胆汁性肝硬化。在慢性活动性肝炎中，对照前瞻性临床试验表明，使用泼尼松龙加或不加硫唑嘌呤时，临床、生化和肝脏组织学均有改善。单独使用硫唑嘌呤并不比安慰剂片有优势。肝硬化可能无法预防。讨论了治疗患者的选择、反应和治疗方案。乙肝表面抗原阳性的慢性活动性肝炎患者的治疗反应比乙肝表面抗原阴性的慢性活动性肝炎患者更差。在原发性胆汁性肝硬化中，由于骨质变薄，皮质类固醇治疗是禁忌的。硫唑嘌呤已用于对照临床试验，仅具有边际效益。
