肿瘤坏死因子拮抗剂在肝病治疗中的应用

Application of tumor necrosis factor antagonists in hepatic disease treatment

所有肿瘤坏死因子(TNF)拮抗剂均可伴有肝毒性从而引起肝损伤,表现HBV或HCV再激活、急性肝炎、药物性肝病、胆汁淤积、血清肝酶增高,甚至发生急性肝衰竭等。因此,在肝病治疗中TNF拮抗剂的应用一直存有争议。综述了TNF拮抗剂的治疗机理及其在肝病中的应用,认为虽然TNF拮抗剂已应用多年,但缺乏对其在各种肝病中应用安全性和有效性的共识,尚需大样本病例随机对照研究。

All tumor necrosis factor（ TNF） antagonists are associated with hepatotoxicity and thus induce liver injury,commonly manifested as hepatitis B virus and hepatitis C virus reactivation,acute hepatitis,drug- induced liver disease,cholestasis,serum liver enzyme activity elevation,and even acute liver failure. Hence,the application of TNF antagonists in hepatic disease treatment remains controversial. This review summarizes currently available data on the mechanism and application of TNF antagonists in hepatic disease treatment. Although TNF antagonists have been applied for many years,large randomized controlled trials are still recommended to assess its efficacy and safety and to achieve a consensus.