炎症性肠病与慢性肝脏疾病的关系及其管理策略

王江滨

doi:10.3969/j.issn.1001-5256.2020.07.002

炎症性肠病与慢性肝脏疾病的关系及其管理策略

DOI: 10.3969/j.issn.1001-5256.2020.07.002

王江滨

吉林大学白求恩第三医院/中日联谊医院消化内科

详细信息

中图分类号: R575;R574
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出版历程
- 出版日期: 2020-07-20

Association between inflammatory bowel disease and chronic liver diseases and related management strategies

Wang JiangBin

Department of Gastroenterology, Bethune Third Hospital/China-Japan Union Hospital of Jilin University, Changchun 130033, China

摘要

摘要:
炎症性肠病(IBD)在多种情况下都可以合并慢性肝脏疾病。IBD与包括原发性硬化性胆管炎、原发性胆汁性胆管炎、自身免疫性肝炎在内的自身免疫性肝病在发病机制上有重叠因素,故合并存在的现象并不少见,其中原发性硬化性胆管炎合并IBD的几率最高,可达80%以上; IBD合并慢性HBV/HCV感染的几率与当地的感染率相关,若在应用免疫抑制剂之前忽略了对HBV/HCV感染的筛查,则存在HBV/HCV感染加重或HBV再激活的发生风险; IBD患者在长期治疗中应用的抗生素、类固醇激素类药物、免疫抑制剂时有诱导药物性肝损伤的可能;尽管IBD患者常因腹泻、吸收障碍等因素导致消瘦,但其合并非酒精性脂肪性肝病的几率却明显高于当地一般人群。
- 炎症性肠病 /
- 肝疾病 /
- 诊断 /
- 治疗学
Abstract:
Inflammatory bowel disease(IBD) is often accompanied by chronic liver diseases in a variety of situations. Due to the overlapping factors in the pathogenesis of IBD and autoimmune liver diseases including primary sclerosing cholangitis( PSC),primary biliary cholangitis,and autoimmune hepatitis,the co-existence of these diseases is not uncommon,among which PSC with IBD has the highest probability of more than 80%. The probability of IBD with chronic hepatitis B virus(HBV)/hepatitis C virus(HCV) infection is associated with local infection rate,and if the screening for HBV/HCV infection is ignored before the application of immunosuppressive agents,there may be a risk of aggravated HBV/HCV infection or HBV reactivation. Long-term treatment with antibiotics,steroids,and immunosuppressants may cause drug-induced liver injury in patients with IBD. Although IBD patients often have weight loss due to the factors including diarrhea and absorption disorders,these patients may have a higher probability of nonalcoholic fatty liver disease than the general population.
- inflammatory bowel disease /
- liver diseases /
- diagnosis /
- therapeutics

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参考文献(39)

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