目的应用Meta分析系统评价熊去氧胆酸单药与联合免疫抑制剂治疗原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征(PBCAIH)的长期疗效及安全性。方法检索Pubmed、Embase、Cochrane图书馆、Web of Science、CBM、中国知网等数据库,检索时限...目的应用Meta分析系统评价熊去氧胆酸单药与联合免疫抑制剂治疗原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征(PBCAIH)的长期疗效及安全性。方法检索Pubmed、Embase、Cochrane图书馆、Web of Science、CBM、中国知网等数据库,检索时限为建库至2020年4月22日,根据纳入及排除标准提取数据,应用Rev Man 5.3软件进行Meta分析。结果共纳入16篇文献,包括621例PBC-AIH患者,其中熊去氧胆酸单药治疗组268例。Meta分析结果显示,与熊去氧胆酸单药治疗相比较,通过联合免疫抑制剂治疗可提高PBC-AIH的生化指标复常率(OR=2.02,95%CI=1.43~2.86,P<0.001),且能有效稳定或减少肝脏纤维化(OR=3.54,95%CI=1.13~11.13,P=0.03)。但长期随访发现,单药治疗与联合治疗肝移植或肝相关死亡事件发生率比较差异无统计学意义(OR=0.64,95%CI=0.25~1.61,P=0.34)。进一步分析显示,两者在非肝硬化PBC-AIH患者不良事件发生率与肝硬化发生率比较差异均无统计学意义(OR=0.63,95%CI=0.30~1.33,P=0.22)(OR=1.31,95%CI=0.43~3.99,P=0.63)。结论熊去氧胆酸联合免疫抑制剂能显著提高PBC-AIH患者的生化指标复常率,有效稳定或减少肝脏纤维化,且不增加非肝硬化PBC-AIH患者不良事件的发生率,但肝硬化和终点事件的发生率与熊去氧胆酸单药治疗相同。展开更多
Some patients present with overlapping features between disorders within the spectrum of autoimmune liver diseases, i.e., autoimmune hepatitis （AIH）, primary biliary cirrhosis （PBC）, and primary sclerosing cholang...Some patients present with overlapping features between disorders within the spectrum of autoimmune liver diseases, i.e., autoimmune hepatitis （AIH）, primary biliary cirrhosis （PBC）, and primary sclerosing cholangitis （PSC）, and are commonly classified as having an ＂overlap syndrome＂. The pathophysiological mechanisms underlying AIH-PBC overlap remain unclear.^（1） Due to the lack of standardization and variations in the populations under study,展开更多
Objective To evaluate the efficacy of ursodeoxycholic acid(UDCA)alone or combined with immunosuppressant in primary biliary cirrhosis-autoimmune hepatitis overlap syndrome(PBC-AIH).Methods From January2001 to December...Objective To evaluate the efficacy of ursodeoxycholic acid(UDCA)alone or combined with immunosuppressant in primary biliary cirrhosis-autoimmune hepatitis overlap syndrome(PBC-AIH).Methods From January2001 to December 2014,41 patients with PBC-AIH were screened out from patients with autoimmune hepatitis(AIH)and retrospectively analyzed.According to展开更多
文摘目的应用Meta分析系统评价熊去氧胆酸单药与联合免疫抑制剂治疗原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征(PBCAIH)的长期疗效及安全性。方法检索Pubmed、Embase、Cochrane图书馆、Web of Science、CBM、中国知网等数据库,检索时限为建库至2020年4月22日,根据纳入及排除标准提取数据,应用Rev Man 5.3软件进行Meta分析。结果共纳入16篇文献,包括621例PBC-AIH患者,其中熊去氧胆酸单药治疗组268例。Meta分析结果显示,与熊去氧胆酸单药治疗相比较,通过联合免疫抑制剂治疗可提高PBC-AIH的生化指标复常率(OR=2.02,95%CI=1.43~2.86,P<0.001),且能有效稳定或减少肝脏纤维化(OR=3.54,95%CI=1.13~11.13,P=0.03)。但长期随访发现,单药治疗与联合治疗肝移植或肝相关死亡事件发生率比较差异无统计学意义(OR=0.64,95%CI=0.25~1.61,P=0.34)。进一步分析显示,两者在非肝硬化PBC-AIH患者不良事件发生率与肝硬化发生率比较差异均无统计学意义(OR=0.63,95%CI=0.30~1.33,P=0.22)(OR=1.31,95%CI=0.43~3.99,P=0.63)。结论熊去氧胆酸联合免疫抑制剂能显著提高PBC-AIH患者的生化指标复常率,有效稳定或减少肝脏纤维化,且不增加非肝硬化PBC-AIH患者不良事件的发生率,但肝硬化和终点事件的发生率与熊去氧胆酸单药治疗相同。
文摘Some patients present with overlapping features between disorders within the spectrum of autoimmune liver diseases, i.e., autoimmune hepatitis （AIH）, primary biliary cirrhosis （PBC）, and primary sclerosing cholangitis （PSC）, and are commonly classified as having an ＂overlap syndrome＂. The pathophysiological mechanisms underlying AIH-PBC overlap remain unclear.^（1） Due to the lack of standardization and variations in the populations under study,
文摘Objective To evaluate the efficacy of ursodeoxycholic acid(UDCA)alone or combined with immunosuppressant in primary biliary cirrhosis-autoimmune hepatitis overlap syndrome(PBC-AIH).Methods From January2001 to December 2014,41 patients with PBC-AIH were screened out from patients with autoimmune hepatitis(AIH)and retrospectively analyzed.According to
