摘要
自身免疫性肝炎(AIH)是一种免疫介导的慢性炎症性肝病,可发生在所有种族、性别和年龄,约30%左右诊断时已发生肝硬化,甚至部分患者出现肝硬化失代偿表现才被考虑诊断,但患者已失去最佳治疗时机。标准免疫抑制治疗(糖皮质激素加或不加硫唑嘌呤)对AIH肝硬化患者而言,尤其是失代偿患者,其不良反应的发生率明显高于非肝硬化患者,且应答率也低于非肝硬化患者。因此早期诊断,早期干预治疗,是改善AIH肝硬化患者转归和延长其生存期的重要措施。对于已进入肝硬化甚至失代偿阶段,如何选择有效且不良反应小的治疗,也是减少肝脏不良事件,改善生存的有效手段。本文将从AIH肝硬化患者的诊治现状和研究进展作一综述,为AIH肝硬化患者的早期诊断和更优化的治疗提供更多临床依据。
Autoimmune hepatitis (AIH) is an immune-mediated chronic inflammatory liver disease that can occur in all races, genders, and ages. About 30% of patients are diagnosed with cirrhosis, and some may even have decompensated liver cirrhosis before being considered for diagnosis. However, patients have lost the optimal treatment opportunity. Standard immunosuppressive therapy (corticosteroids with or without azathioprine) has a significantly higher incidence of adverse reactions in AIH cirrhosis patients, especially in decompensated patients, and a lower response rate compared to non cirrhosis patients. Therefore, early diagnosis and intervention treatment are important measures to improve the prognosis and prolong the survival of AIH cirrhosis patients. For those who have achieved the stage of cirrhosis or even decompensation, choosing effective and minimally adverse treatments is also an effective way to reduce liver adverse events and improve survival. This article will provide a review of the current diagnosis and treatment status and research progress of AIH cirrhosis patients, providing more clinical evidence for early diagnosis and more optimized treatment of AIH cirrhosis patients.
出处
《临床医学进展》
2024年第4期797-805,共9页
Advances in Clinical Medicine
