原发性胆汁性胆管炎对熊去氧胆酸应答不佳的影响因素及治疗进展

武鑫月; 杜文军

doi:10.12449/JCH260929

原发性胆汁性胆管炎对熊去氧胆酸应答不佳的影响因素及治疗进展

DOI: 10.12449/JCH260929

武鑫月,
杜文军^, ,

山东大学附属公共卫生临床中心肝病诊疗中心，济南 250101

基金项目:

山东省自然科学基金 (ZR2023MH143)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：杜文军负责确定选题及论文审阅；武鑫月负责查阅文献及论文撰写。

详细信息

通信作者:
杜文军， crbdwj@126.com （ORCID： 0000-0002-6753-5910）

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出版历程
- 收稿日期: 2026-01-07
- 录用日期: 2026-03-05
- 出版日期: 2026-09-25

Influencing factors for suboptimal response to ursodeoxycholic acid in primary biliary cholangitis and related advances in treatment

Xinyue Wu,
Wenjun Du^{,
,}

Division of Liver Disease Center，Public Health Clinical Center Affiliated to Shandong University，Jinan 250101，China

Research funding:

Shandong Provincial Natural Science Foundation (ZR2023MH143)

More Information

Corresponding author: Du Wenjun， crbdwj@126.com （ORCID： 0000-0002-6753-5910）

摘要

摘要: 原发性胆汁性胆管炎（PBC）是一种自身免疫介导的慢性胆汁淤积性肝病，熊去氧胆酸（UDCA）是PBC一线治疗药物，部分UDCA生化应答不佳的患者疾病进展风险显著增加，且预后不良。本文系统综述了目前常用的生化应答标准，并从遗传背景、人口学因素、免疫学特征和肠-肝轴等多个方面对影响UDCA应答不佳的相关因素及潜在机制进行分析。同时，总结现有二线治疗药物及新兴疗法，以期为早期识别高风险患者、优化治疗策略提供依据，为未来研究方向提供参考。
- 肝硬化，胆汁性 /
- 熊去氧胆酸 /
- 治疗结果 /
- 影响因素分析
Abstract: Primary biliary cholangitis （PBC） is an autoimmune-mediated chronic cholestatic liver disease. Ursodeoxycholic acid （UDCA） is the first-line treatment drug for PBC， yet some patients with suboptimal biochemical response to UDCA face a significant increase in the risk of disease progression and often have a poor prognosis. This article systematically summarizes the currently established criteria for biochemical response and analyzes the factors and underlying mechanisms associated with suboptimal UDCA response from multiple perspectives including genetic background， demographic factors， immunological features， and the gut-liver axis. Furthermore， it outlines the available second-line treatment drugs and emerging therapies， in order to provide a basis for early identification of high-risk patients and optimization of treatment strategies， as well as a reference for future research directions.
- Liver Cirrhosis， Biliary /
- Ursodeoxycholic Acid /
- Treatment Outcome /
- Root Cause Analysis

HTML全文

注： UDCA，熊去氧胆酸；HLA，人类白细胞抗原；TMEM163，跨膜蛋白163；PPAR，过氧化物酶体增殖物激活受体；CCL，C-C基序趋化因子配体，CCR，C-C基序趋化因子受体；CXCL，C-X-C基序趋化因子配体；PI3K/AKT，磷脂酰肌醇3-激酶/蛋白激酶B；lncRNA，长链非编码RNA；mRNA，信使RNA；FXR，法尼醇X受体；SHP，小异源二聚体伴侣；CYP7A1，细胞色素P450家族7亚家族A成员1；BA，胆汁酸；CA，胆酸；CDCA，鹅去氧胆酸；BSEP，胆盐输出泵；MRP3，多药耐药相关蛋白3；BSH，胆盐水解酶；ASBT，顶端钠依赖性胆汁酸转运蛋白；NTCP，牛磺胆酸钠共转运蛋白；Erα，雌激素受体α；AR，雄激素受体；Tfh，滤泡辅助性T细胞；Treg，调节性T细胞；IL-21，白细胞介素21；Th17，辅助性T细胞17；IFN-γ，干扰素γ；OCA，奥贝胆酸；ALP，碱性磷酸酶。

图 1 原发性胆汁性胆管炎熊去氧胆酸应答不佳的影响因素及新兴疗法

Figure 1. Factors affecting incomplete response to ursodeoxycholic acid in primary biliary cholangitis and emerging therapies

下载: 全尺寸图片幻灯片

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