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皮质类固醇治疗原发性胆汁性肝硬化(简称PBC)未曾给予适当的估价,一般认为没有价值,甚至认为禁忌,因其可加速骨质疏松。然而,PBC的血清学免疫特性和肝内淋巴细胞、浆细胞浸润,提示应用全身或局部皮质类固醇治疗可能有益。由于作者等发现胆汁中强的松龙比其它皮质类固醇较高,因而连续对10例有症状的PBC患者研究了每天应用强的松龙30→10mg的作用。这些患者的血清碱性磷酸酶≥2倍于正常,抗线粒体抗体≥1:80,血清IgM升高,肝外胆管造影正常,肝组织学显示汇管区淋巴细胞浸润、肝小叶间胆管数减少和/或破坏的胆管周围有肉芽肿。全部患者同时口服青霉胺250mg。另外,25例PBC与25名年龄和性别配对的正常对照者,在骨质疏松方面作了比较。
Corticosteroids Primary biliary cirrhosis (referred to as PBC) has not given appropriate valuation, generally considered of no value, or even considered taboo because it can accelerate osteoporosis. However, the serological immune characteristics of PBC and intrahepatic lymphocytes, plasma cell infiltration, suggest that systemic or topical corticosteroid therapy may be beneficial. Since the authors found that prednisolone in bile was higher than other corticosteroids, 10 consecutive doses of prednisolone 30? 10 mg were continuously studied in 10 symptomatic PBC patients. These patients had serum alkaline phosphatase ≥2 times normal, anti-mitochondrial antibodies ≥1: 80, elevated serum IgM, normal extrahepatic cholangiography, histological examination of lymphocytes in the portal area and reduction in the number of interlobular bile ducts and / Or destruction of the bile duct around the granuloma. All patients also oral penicillamine 250mg. In addition, 25 cases of PBC with 25 age-and-sex paired normal controls were compared in terms of osteoporosis.