Clinical features and management of primary sclerosing cholangitis.

Clinical features and management of primary sclerosing cholangitis.
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原发性硬化性胆管炎的临床特征和治疗。

DOI:
--
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发表时间:
2008
影响因子:
4.3
通讯作者:
K. Lindor
K. Lindor
中科院分区:
医学2区
文献类型:
--
作者:
M. Silveira;K. Lindor

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原发性硬化性胆管炎是一种慢性胆汁淤积性肝病,其特征是胆管炎症和纤维化,导致肝硬化,需要肝移植和预期寿命缩短。大多数病例发生在年轻和中年男性中,通常与炎症性肠病有关。原发性硬化性胆管炎的病因包括免疫介导的成分和性质不明的因素。尚未发现有效的药物治疗。原发性硬化性胆管炎的多种并发症包括代谢性骨病、显性狭窄、细菌性胆管炎和恶性肿瘤,特别是胆管癌,胆管癌是原发性硬化性胆管炎最致命的并发症。肝移植是目前终末期疾病患者唯一的延长生命的治疗选择,尽管已经描述了同种异体移植肝的复发。PSC样变异引起注意的是胆管炎,其特征是免疫球蛋白G4亚类水平升高、病变内浆细胞突出和类固醇反应性。
Primary sclerosing cholangitis is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts, resulting in cirrhosis and need for liver transplantation and reduced life expectancy. The majority of cases occur in young and middle-aged men, often in association with inflammatory bowel disease. The etiology of primary sclerosing cholangitis includes immune-mediated components and elements of undefined nature. No effective medical therapy has been identified. The multiple complications of primary sclerosing cholangitis include metabolic bone disease, dominant strictures, bacterial cholangitis, and malignancy, particularly cholangiocarcinoma, which is the most lethal complication of primary sclerosing cholangitis. Liver transplantation is currently the only life-extending therapeutic alternative for patients with end-stage disease, although recurrence in the allografted liver has been described. A PSC-like variant attracting attention is cholangitis marked by raised levels of the immunoglobulin G4 subclass, prominence of plasma cells within the lesions, and steroid responsiveness.
肝硬化期原发性硬化性胆管炎患者是否有发展为肝细胞癌的风险?
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