炎症性肠病与免疫性肝病的研究进展

Research progress of inflammatory bowel disease and immuno-hepatopathy

炎症性肠病(inflammatory bowel disease,IBD)包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(crohn’s disease,CD),是一种特发性肠道炎症性疾病。IBD临床表现复杂,除慢性非特异性肠道炎症外,还有皮肤、骨骼、肌、肺、肝、胆、肾脏等多个器官或系统的肠外表现。肝胆并发症因其与IBD愈后密切相关而受到关注。肝胆系统病变包括药物性肝损伤、胆结石、非酒精性脂肪肝等显性疾病,但是另外症状隐匿、特异性不强,且部分独立于肠道炎症外的免疫性肝病,如原发性硬化性胆管炎(primary sclerosing cholagitis,PSC)、小胆管性PSC、原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)、自身免疫性肝炎(AIH)、PSC/AIH重叠综合征以及Ig4相关性胆管炎容易被忽视。本文就与IBD相关的免疫性肝病的研究进展进行综述。

Inflammatory bowel disease （IBD）,including ulcerative colitis （UC） and Crohn＇s disease（CD）,is an idiopathic inflammatory bowel disease with complex clinical manifestation.Except non-specific chronic inflammatory conditions of the gastrointestinal tract,several organization or system pathological changes,like skin,bones,muscles,lungs,kidneyas well as hepatobiliary system,are extraintestinal manifestations of IBD.The complications of hepatobiliary system have drawn more attention due to its close relation with prognosis of IBD.In addition to the dominance complications of drug-induced liver damage,gallstones,nonalcoholic fatty liver disease in hepatobiliary system,other auto immuno-hepatopathies are neglected easily,which are characterized by latent,nonspecific and partly independent of intestinal inflammation,such as primary sclerosing cholangitis,a small bile ducts of PSC,primary biliary cirrhosis （PBC）,autoimmune hepatitis （AIH）,PSC/AIH overlap syndrome,Ig4 related cholangitis and so on.In this paper,the research progress of immuno-hepatopathies closed associated with IBD was reviewed in order to provide reliable message for early diagnosis and treatment.