自身免疫样药物性肝损伤的研究现状与进展

摘要/Abstract

摘要： 药物性肝损伤(drug-induced liver injury,DILI)是临床上常见的肝功能受损的主要原因之一,其中称之为自身免疫样DILI(autoimmune-like DILI,AL-DILI)是一种特殊的疾病亚型,与自身免疫性肝炎(autoimmune hepatitis,AIH) 有着相似的临床表现和组织学特征,在临床上难以鉴别,且易与之混淆。AL-DILI的发生机制尚不明确,目前考虑与新抗原的形成、遗传易感性和免疫耐受性受损等多种因素有关。导致AL-DILI的药物有不同种,且有不同的的实验室表现。目前较为公认的诊断方法是在排除其他疾病的基础上采用因果关系评估法。AL-DILI尚无特异性实验室检查征象,与AIH鉴别困难,在治疗上可诊断性应用糖皮质激素,且疾病一般不会复发。本文通过阐述AL-DILI的发病机制、导致AL-DILI的常见药物、诊断、鉴别诊断、治疗等,以期对临床诊治有一定的指导意义。

次白, 邓晓玲, 侯淑惠, 徐可树. 自身免疫样药物性肝损伤的研究现状与进展[J]. 肝脏, 2023, 28(10): 1149-1153.

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