胆汁淤积性肝病相关皮肤瘙痒的机制和治疗进展

Update on pathogenesis and management of pruritus in cholestatic liver disease

胆汁淤积性肝病如原发性胆汁性肝硬化、原发性硬化性胆管炎和妊娠期肝内胆汁淤积症,很常见的一个临床表现是皮肤瘙痒。其确切的发病机制仍不清楚,几种介质可能在其发病机制中发挥了一定作用,如溶血磷脂酸、胆盐、阿片类物质、组胺和孕酮的代谢产物。我们对其发病机制和治疗的研究进展作一综述,以便更好的认识和治疗胆汁淤积患者的皮肤瘙痒。

Pruritus is one of the common clinical manifestations of cholestatic liver diseases such as primary biliary cirrhosis （PBC）, primary sclerosing eholangitis （PSC） and intrahepatic cholestasis of pregnancy （ICP）. The exact pathogenesis remains obscure with several mediators possibly playing an important role; these include lysophosphatidic acid, bile salts, opioids, histamine and progesterone metabolites. We described in this review recent update on the pathogenesis and management of pruritus in patients with cholestasis in order to improve the understanding and manage- ment of pruritus.