自身免疫性肝脏疾病的诊治进展_West China Medical Journal

Authors：

 赵倩 ,  雷学忠

四川大学华西医院感染性疾病中心（成都, 610041）;

Corresponding author：

雷学忠, Email: lxzy@163.com

Keywords：

自身免疫性肝炎; 原发性胆汁性肝硬化; 原发性硬化性胆管炎; 诊断; 治疗

DOI：

10.7507/1002-0179.20140361

Video：

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自身免疫性肝脏疾病（ALD）是以血清出现多种自身抗体，并作用于肝脏这一靶器官，从而导致肝功能损害的一组疾病。临床上主要以慢性起病为主，出现乏力、食欲减退、黄疸等慢性肝功能损害的表现，也可逐渐进展至肝硬化，甚至肝癌。随着临床诊疗技术及检验技术的发展，有关ALD的发病机制、诊断治疗的研究日趋明朗，现对各类ALD的发病机制、病理特征、诊断及治疗作一阐述。

Citation： 赵倩, 雷学忠. 自身免疫性肝脏疾病的诊治进展. West China Medical Journal, 2014, 29(6): 1174-1177. doi: 10.7507/1002-0179.20140361 Copy

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16.	Manns MP, Czaja AJ, Gorham JD, et al. Diagnosis and management of autoimmune hepatitis[J]. Hepatology, 2010, 51(6): 2193-2213.
17.	Hirschfield GM, Al-Harthi N, Heathcote EJ. Current status of therapy in autoimmune liver disease[J]. Therap Adv Gastroenterol, 2009, 2(1): 11-28.
18.	Kaplan MM, Gershwin ME. Primary biliary cirrhosis[J]. N Engl J Med, 2005, 353(12): 1261-1273.
19.	Lleo A, Battezzati PM, Selmi C, et al. Is autoimmunity a matter of sex?[J]. Autoimmun Rev, 2008, 7(8): 626-630.
20.	Selmi C, Invernizzi P, Zuin M, et al. Genetics and geoepidemiology of primary biliary cirrhosis: following the footprints to disease etiology[J]. Semin Liver Dis, 2005, 25(3): 265-280.
21.	Invernizzi P, Selmi C, Mackay IR, et al. From bases to basis: linking genetics to causation in primary biliary cirrhosis[J]. Clin Gastroenterol Hepatol, 2005, 3(5): 401-410.
22.	Invernizzi P, Gershwin ME. The genetics of human autoimmune disease[J]. J Autoimmun, 2009, 33(3-4): 290-299.
23.	Selmi C, Gershwin ME. The role of environmental factors in primary biliary cirrhosis[J]. Trends Immunol, 2009, 30(8): 415-420.
24.	European Association for the Study of the Liver. EASL clinical practice guidelines: management of cholestatic liver diseases[J]. J Hepatol, 2009, 51(2): 237-267.
25.	Crosignani A, Battezzati PM, Invernizzi P, et al. Clinical features and management of primary biliary cirrhosis[J]. World J Gastroenterol, 2008, 14(21): 3313-3327.
26.	Cullen SN, Chapman RW. The medical management of primary sclerosing cholangitis[J]. Semin Liver Dis, 2006, 26(1): 52-61.
27.	Maggs JR, Chapman RW. An update on primary sclerosing cholangitis[J]. Curr Opin Gastroenterol, 2008, 24(3): 377-383.
28.	Lazaridis KN, Gores GJ. Primary sclerosing cholangitis and cholangiocarcinoma[J]. Semin Liver Dis, 2006, 26(1): 42-51.
29.	Silveira MG, Lindor KD. Clinical features and management of primary sclerosing cholangitis[J]. World J Gastroenterol, 2008, 14(21): 3338-3349.
30.	Vogel A, Wedemeyer H, Manns MP, et al. Autoimmune hepatitis and overlap syndromes[J]. J Gastroenterol Hepatol, 2002, 17(Suppl 3): 389-398.
31.	Czaja AJ. The overlap syndromes of autoimmune hepatitis[J]. Dig Dis Sci, 2013, 58(2): 326-343.
32.	Mieli-Vergani G, Vergani D. Autoimmune paediatric liver disease[J]. World J Gastroenterol, 2008, 14(21): 3360-3367.

1. Lata J. Diagnosis and treatment of autoimmune hepatitis[J]. Dig Dis, 2012, 30(2): 212-215.
2. Longhi MS, Ma Y, Mieli-Vergani G, et al. Aetiopathogenesis of autoimmune hepatitis[J]. J Autoimmun, 2010, 34(1): 7-14.
3. Invernizzi P. Geoepidemiology of autoimmune liver diseases[J]. J Autoimmun, 2010, 34(3): 300-306.
4. Czaja AJ. Autoimmune liver disease and rheumatic manifestations[J]. Curr Opin Rheumatol, 2007, 19(1): 74-80.
5. Donaldson PT. Genetics in autoimmune hepatitis[J]. Semin Liver Dis, 2002, 22(4): 353-364.
6. Czaja AJ, Bianchi FB, Carpenter HA, et al. Treatment challenges and investigational opportunities in autoimmune hepatitis[J]. Hepatology, 2005, 41(1): 207-215.
7. 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): 929-938.
8. Czaja AJ. Performance parameters of the diagnostic scoring systems for autoimmune hepatitis[J]. Hepatology, 2008, 48(5): 1540-1548.
9. Hennes EM, Zeniya M, Czaja AJ, et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology, 2008, 48(1): 169-176.
10. Feld JJ, Dinh H, Arenovich T, et al. Autoimmune hepatitis: effect of symptoms and cirrhosis on natural history and outcome[J]. Hepatology, 2005, 42(1): 53-62.
11. Gleeson D, Heneghan MA, British society of gastroenterology.British society of gastroenterology (BSG) guidelines for management of autoimmune hepatitis[J]. Gut, 2011, 60(12): 1611-1629.
12. Czaja AJ. Features and Consequences of untreated type 1 autoimmune hepatitis[J]. Liver Int, 2009, 29(6): 816-823.
13. Trivedi PJ, Hirschfield GM. Treatment of autoimmune liver disease: current and future therapeutic options[J]. Ther Adv Chronic Dis, 2013, 4(3): 119-141.
14. Manns MP, Woynarowski M, Kreisel W, et al. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis[J]. Gastroenterology, 2010, 139(4): 1198-1206.
15. Montano-Loza AJ, Carpenter HA, Czaja AJ. Consequences of treatment withdrawal in type 1 autoimmune hepatitis[J]. Liver Int, 2007, 27(4): 507-515.
16. Manns MP, Czaja AJ, Gorham JD, et al. Diagnosis and management of autoimmune hepatitis[J]. Hepatology, 2010, 51(6): 2193-2213.
17. Hirschfield GM, Al-Harthi N, Heathcote EJ. Current status of therapy in autoimmune liver disease[J]. Therap Adv Gastroenterol, 2009, 2(1): 11-28.
18. Kaplan MM, Gershwin ME. Primary biliary cirrhosis[J]. N Engl J Med, 2005, 353(12): 1261-1273.
19. Lleo A, Battezzati PM, Selmi C, et al. Is autoimmunity a matter of sex?[J]. Autoimmun Rev, 2008, 7(8): 626-630.
20. Selmi C, Invernizzi P, Zuin M, et al. Genetics and geoepidemiology of primary biliary cirrhosis: following the footprints to disease etiology[J]. Semin Liver Dis, 2005, 25(3): 265-280.
21. Invernizzi P, Selmi C, Mackay IR, et al. From bases to basis: linking genetics to causation in primary biliary cirrhosis[J]. Clin Gastroenterol Hepatol, 2005, 3(5): 401-410.
22. Invernizzi P, Gershwin ME. The genetics of human autoimmune disease[J]. J Autoimmun, 2009, 33(3-4): 290-299.
23. Selmi C, Gershwin ME. The role of environmental factors in primary biliary cirrhosis[J]. Trends Immunol, 2009, 30(8): 415-420.
24. European Association for the Study of the Liver. EASL clinical practice guidelines: management of cholestatic liver diseases[J]. J Hepatol, 2009, 51(2): 237-267.
25. Crosignani A, Battezzati PM, Invernizzi P, et al. Clinical features and management of primary biliary cirrhosis[J]. World J Gastroenterol, 2008, 14(21): 3313-3327.
26. Cullen SN, Chapman RW. The medical management of primary sclerosing cholangitis[J]. Semin Liver Dis, 2006, 26(1): 52-61.
27. Maggs JR, Chapman RW. An update on primary sclerosing cholangitis[J]. Curr Opin Gastroenterol, 2008, 24(3): 377-383.
28. Lazaridis KN, Gores GJ. Primary sclerosing cholangitis and cholangiocarcinoma[J]. Semin Liver Dis, 2006, 26(1): 42-51.
29. Silveira MG, Lindor KD. Clinical features and management of primary sclerosing cholangitis[J]. World J Gastroenterol, 2008, 14(21): 3338-3349.
30. Vogel A, Wedemeyer H, Manns MP, et al. Autoimmune hepatitis and overlap syndromes[J]. J Gastroenterol Hepatol, 2002, 17(Suppl 3): 389-398.
31. Czaja AJ. The overlap syndromes of autoimmune hepatitis[J]. Dig Dis Sci, 2013, 58(2): 326-343.
32. Mieli-Vergani G, Vergani D. Autoimmune paediatric liver disease[J]. World J Gastroenterol, 2008, 14(21): 3360-3367.

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自身免疫性肝脏疾病的诊治进展

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