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Efficacy of ursodeoxycholic acid in the treatment of type Ⅰ autoimmune hepatitis
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摘要: 观察熊去氧胆酸 （UDCA）对Ⅰ型自身免疫性肝炎的疗效。随机选取 4 2例Ⅰ型自身免疫性肝炎分为三组 ,分别采用UDCA（A组 ） ,皮质类固醇激素 +UDCA （B组 ）和单纯皮质类固醇激素 （C组 ）治疗八周 ,观察患者症状、肝功能及免疫学指标的变化。B组和C组均能较好地改善症状和A组比较有显著差异性 （P <0 0 5 ） ,TBil、ALT、γ -GT以及IgGB组和C组均较A组明显改善 （P <0 0 5 ） ,B、C组间比较有显著差异 （P <0 0 5 ） ;B组产生副作用与C组比较差异显著 （P <0 0 5 ）。UDCA与皮质类固醇激素合用能有较好疗效 ,可以减少其使用量及副作用Abstract: To observe the efficacy and safety of ursodeoxycholic acid in the treatment of type Ⅰ autoimmune hepatitis. 42 patients with type Ⅰ autoimmune hepatitis were randomly divided into groups A, B and C. Patients in group A received ursodeoxycholic acid in group B received ursodeoxycholic acid and succinate hydrocortisone in group C received succinate hydrocortison for eight weeks. At the end of treatment the effective in group A was less than that in group B and C, which were significantly differences in all groups (P<0.05) .TBil, TBA, ALT, γ-GT and IgG were lower in group B than in group C (P<0.05) . the effect negative in group B was less than that in group C (P<0.05) . Ursodeoxycholic acid could not replace succinate hydrocortisone in treat type Ⅰ autoimmune hepatitis, but it combined succinate hydrocortisone could decrease the quantities of succinate hydrocortisone.
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Key words:
- autoimmune hepatitis /
- ursodeoxycholic acid /
- succinate hydrocortisone
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【据Journal of Gastroenterology and Hepatology 2021年1月报道】题：自发性脾肾分流对肝硬化患者长期生存的影响(作者Yi F等)
自发性脾肾分流(SSRS)是肝硬化门静脉高压的表现之一。然而，SSRS对肝硬化患者长期生存的影响尚不清楚。来自北部战区总医院消化内科的Yi等推测SSRS可能通过减少肝血流灌注使肝功能恶化，并增加肝硬化死亡的风险。
研究筛选了于2014年12月—2019年8月连续住院且接受腹部增强CT/MRI检查的肝硬化患者。测量门静脉系血管和SSRS的最大直径，计算肝腹面积比(LAAR)。对所有患者进行随访，最后一次随访日期为2019年8月31日。研究共纳入122例肝硬化患者，其中30.3%发现有SSRS，SSRS患者门静脉右支、门静脉主干最大直径和LAAR评分中位数明显小于无SSRS患者(9 mm vs 11.20 mm、15.30 mm vs 16.80 mm、25.39 vs 31.58，P值分别为0.001、0.017、＜0.001)；SSRS患者Child-Pugh B/C级占比、MELD评分中位数、死亡率明显高于无SSRS患者(62.1% vs 43.5%、12.17 vs 9.79、18.9% vs 4.7%，P值分别为0.026、0.006、0.012)。Kaplan-Meier曲线分析发现，SSRS患者累积生存率明显低于无SSRS患者(P=0.014)。Cox回归分析显示，SSRS是肝硬化患者死亡率增加的危险因素(RR=4.161，95%CI: 1.215~14.255，P=0.023)。
研究表明，肝硬化SSRS患者的门静脉直径更细，肝功能更差，肝体积更小，死亡率更高。
摘译自YI F, GUO X, WANG L, et al. Impact of spontaneous splenorenal shunt on liver volume and long-term survival of liver cirrhosis[J]. J Gastroenterol Hepatol, 2021. [Online ahead of print]. DOI: 10.1111/jgh.15386.
(北部战区总医院消化内科 易芳芳 祁兴顺 报道)
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[1]Alvarez F, Berg PA, Bianchi FB, et al. International Autoimmune hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol, 1999, 31 (5) ∶929-38. [2]Desmet VJ, Gerber M, Hoofnagle JH. Glassification of chronic hepatitis: diagnosis grading and staging[J]. Hepatology, 1994, 19 (6) ∶1513-20. [3]Nakamura K, Yoneda M, Yokohama S, et al. Efficacy of ursodeoxycholic acid in Japanese patients with type 1 autoimmune hepatitis[J]. J Gastroenterol Hepatol, 1998, 13 (5) ∶490-5. [4]Lindor KD, Dickson ER, Baldus WP, et al. Ursodeoxycholic acid in the treatment of primary biliary cirrhosis[J]. Gastroenterology, 1994, 106 (5) ∶1284-90. [5]Calmus Y, Guechot J, Podevin P, et al. Differential effects of chenodeoxycholic and ursodeoxycholic acids on interleukin 1, interleukin 6 and tumor necrosis factor-alpha production by monocytes[J]. Hepatology, 1992, 16 (3) ∶719-23. [6]Nakamura K, Akiyama K, Makino Ⅰ. Effect of long-term ursodeoxycholic acid treatment on serum liver enzyme and serum bile acid metabolism in chronic hepatitis[J]. Nippon Shokakibyo Gakkai Zasshi, 1995, 92 (1) ∶62-71. [7]Kiso S, Kawata S, Imai Y, et al. Efficacy of ursodeoxycholic acid therapy in chronic viral hepatitis C with high serum gamma-glutamyl transpeptidase levels[J]. J Gastroenterol, 1996, 31 (1) ∶75-80. [8]Janowitz P, Kratzer W, Wechsler JG. Positive effect of ursodeoxycholic acid on liver enzymes in autoimmune hepatitis with little cutivity pilot study[J].Leber Magen Darm, 1996, 26 (6) ∶310-3. -
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