自身免疫性肝炎诊治进展

doi:10.3969/j.issn.1000-8535.2023.06.001

广州医药 ›› 2023, Vol. 54 ›› Issue (6): 1-6.DOI: 10.3969/j.issn.1000-8535.2023.06.001

• 专家综述 • 下一篇

自身免疫性肝炎诊治进展

陈慧婷, 周永健

广州市第一人民医院消化内科,华南理工大学附属第二医院消化内科,广州消化疾病中心（广州 510180）

收稿日期:2023-02-21 出版日期:2023-06-20 发布日期:2023-07-27
通讯作者: 周永健,E-mail：eyzhouyongjian@scut.edu.cn
作者简介:周永健博士,主任医师,博士生导师; 国家临床重点专科广州市第一人民医院消化内科行政主任,广州市医学重点学科带头人,广州市高层次卫生人才; 现任中华医学会肝病学分会委员、中国健康促进基金会肠道微生态与肠菌移植专业委员会副主任委员、广东省医学会肝病分会主任委员、广州市医师协会内镜分会主任委员、炎症性肠病诊疗区域中心主任等; 近五年主持国家自然科学基金面上项目2项、广东省自然科学基金2项、广州市科技计划重点及面上项目各1项、广州市高新技术项目1项和市厅级课题多项,以第一作者或通讯作者发表SCI论文31余篇; 主要研究方向：发展、创新及完善基于肠道微生态多组学分析与标准化肠道菌群重建的消化系统疾病诊疗技术; 从肠道微生态、非编码RNA、免疫调控、表观遗传等方面深入研究消化系统疾病的致病菌及其内在致病分子机制,并为这些疾病提供完善的以调控肠道菌群为基础的诊疗方案。
基金资助:
国家自然科学基金（81970507,82170585）; 广东省自然科学基金（2021A1515011290）; 广州市科技计划项目（202102010023）; 广州市卫健委-高新技术项目（2019GX05）; 广州市医学重点学科（2021-2023）

Advances in the diagnosis and treatment of autoimmune hepatitis

CHEN Huiting, ZHOU Yongjian

Department of Gastroenterology and Hepatology,Guangzhou First People's Hospital,the Second Affiliated Hospital,School of Medicine,South China University of Technology,Guangzhou Digest Disease Centre,Guangzhou 510180,China

Received:2023-02-21 Online:2023-06-20 Published:2023-07-27

摘要/Abstract

摘要： 自身免疫性肝炎（AIH）是由不明原因免疫异常引起的急性或慢性肝脏炎症性疾病,不分年龄或性别,影响所有种族群体。AIH如果没有得到及时的治疗,可能会发展为肝硬化、肝衰竭,甚至导致死亡。目前一些诊断评分系统和肝活组织病理检查已成为诊断的标准,然而由于疾病表现的高度异质性,AIH诊断仍很有挑战性。大多数患者最初对一线治疗（糖皮质激素与硫唑嘌呤的联合治疗）有应答,然而,应答欠佳和因不良反应引起的不耐受也不少见,需要二线和（或）三线治疗。本文总结阐述诊断困难、一线药物治疗应答欠佳或不耐受的疑难AIH诊断和管理的最新进展,并归纳了目前国内外关于AIH治疗的新方法,为AIH的临床诊疗提供参考。

关键词: 自身免疫性肝炎, 应答欠佳, 诊断, 治疗

Abstract: Autoimmune hepatitis（AIH）is an acute or chronic inflammatory disease of liver caused by unclear immune response that affects people from all ethnic groups irrespective of age or sex．If left untreated,AIH will lead to cirrhosis,liver failure,or death．A number of diagnostic scoring systems and histopathological examination of liver biopsies are now the standard for diagnosis．However,due to the high heterogeneity of the disease presentation,AIH diagnosing remains challenging．Most patients initially respond to first-line treatment,which is corticosteroids combined with azathioprine．However,insufficient response and intolerance due to side effects are also common,so some patients requires second-and/or third-line therapies．Here we summarized the latest progress in diagnosis and management of AIH with difficult diagnosis,poor response to first-line drug treatment or intolerance,as well as the new methods of AIH treatment worldwide,to provide reference for the clinical diagnosis and treatment of AIH．

Key words: autoimmune hepatitis, poor response, diagnosis, treatment

陈慧婷, 周永健. 自身免疫性肝炎诊治进展[J]. 广州医药, 2023, 54(6): 1-6.

CHEN Huiting, ZHOU Yongjian. Advances in the diagnosis and treatment of autoimmune hepatitis[J]. Guangzhou Medical Journal, 2023, 54(6): 1-6.

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自身免疫性肝炎诊治进展

Advances in the diagnosis and treatment of autoimmune hepatitis

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