肝中炎症细胞及炎性介质在胆道闭锁发病中的研究进展

Research advances of inflammatory cells and mediators in liver pathology of biliary atresia

胆道闭锁(biliary atresia,BA)是一种以肝内外胆道进行性梗阻和纤维化、肝实质纤维化和炎症为特征的新生儿肝胆系统疾病。BA的具体发病机制仍不是很清楚,肝内外继发性持续性炎性反应可能是其致病机制之一。Kasia手术治疗是胆道闭锁目前治疗的主要方法,然而大部分患儿术后仍会出现退黄效果不佳、胆管炎反复发作等情况,最终需要肝移植。这可能与患儿长期的肝内外胆管持续性进行性炎性反应有关。目前的研究发现肝组织中除了炎症细胞的浸润外还有大量炎性介质的分泌,它们共同参与或介导炎性反应。因此在阅读大量文献的基础上,本文就胆道闭锁肝中炎症细胞及炎性介质浸润的研究进展做一论述,以期对后续胆道闭锁的抗炎治疗提供一定的指导作用。

Biliary atresia(BA)is a neonatal liver disease characterized by progressive obstruction and fibrosis of intra/extrahepatic biliary tracts and fibrosis and inflammation of hepatic parenchyma.Its specific pathogenesis has remained elusive.Secondary persistent inflammatory reaction inside/outside liver may be one of its pathogenesis.Currently Kasia operation is a major treatment for BA.However,most children are still troubled by poor jaundice clearance and recurrent postoperative cholangitis after operation and liver transplantation is often required.This may be correlated with the long-term persistent progressive inflammatory responses of intra/extrahepatic bile ducts.Besides an infiltration of inflammatory cells,excessive secretion of inflammatory mediators is also present in hepatic tissues participating in or mediating inflammation.This review focused upon the research advances of inflammatory cells and inflammatory media infiltration in liver of BA children to provide some guidance for follow-up anti-inflammatory treatment of BA.