与炎症性肠病相关的肝病

Juferdy Kurniawan, Refael Alfa Budiman
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摘要

炎症性肠病(IBD)是一种以胃肠道持续炎症为特征的慢性疾病,包括溃疡性结肠炎(UC)和克罗恩病(CD)。目前,IBD 在西方国家的全球发病率超过 0.3%,而印度尼西亚的发病率相对较低,但预测表明 2020 年至 2050 年的发病率可能会上升。肝胆表现是 IBD 最常见的肠外表现之一。一些与 IBD 相关的肝病具有相似的背景免疫反应、炎症反应、相似的风险因素,或者是由于 IBD 的治疗所致。原发性硬化性胆管炎(PSC)与 IBD 关系密切,两者都会影响对方的预后和疾病进展。非酒精性脂肪肝(NAFLD)也有共同的代谢风险因素。用于治疗 IBD 的一些药物可能会导致肝损伤,尤其是由于 IBD 的治疗时间较长。乙型肝炎再激活是IBD患者长期使用免疫抑制剂后发现的另一个令人担忧的问题。因此,定期密切监测肝功能检测是筛查 IBD 患者肝脏疾病的一项强制性检测。 关键词:炎症性肠病 肝病 自身免疫性肝炎 药物性肝损伤
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Liver Disease Associated with Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) is a chronic condition characterized by persistent inflammation of the gastrointestinal tract, comprising ulcerative colitis (UC) and Crohn’s disease (CD). While the current global incidence of IBD exceeds 0.3% in Western nations, Indonesia reports a comparatively lower prevalence however with projections indicate a potential rise in incidence from 2020 to 2050. Hepatobiliary manifestation is one of the most common extraintestinal manifestations of IBD. Some of the liver disease associated with IBD had similar background immune response, inflammatory reaction, similar risk factor, or due to the treatment of IBD. Primary sclerosing cholangitis (PSC) has close association with IBD and both affect the prognostic and disease progression of each other. Non-alcoholic fatty liver disease (NAFLD) shares common metabolic risk factors. Several drugs used as the treatment of IBD might cause hepatic injury especially due to the long treatment duration of IBD. Hepatitis B reactivation is another concerning event found after prolonged used of immunosuppressive drugs of IBD. Therefore, close monitoring of liver function test periodically is a mandatory test to screen liver disease in IBD patients.  Keyword: Inflammatory bowel disease, liver disease, autoimmune hepatitis, drug-induced liver injury
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