婴幼儿胆汁淤积:基于病理机制的治疗进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v8i2.18892
Abstract
婴幼儿胆汁淤积是由胆汁酸代谢紊乱、胆管发育异常或肝细胞转运缺陷引起的临床综合征,其病因复杂且高度异质性。近年来,随着分子机制研究的深入,靶向治疗取得显著进展:回肠胆汁酸转运蛋白(IBAT)抑制剂(如奥德昔巴特)通过阻断胆汁酸肠肝循环改善进行性家族性肝内胆汁淤积症2型(PFIC2)患者症状;法尼醇X受体(FXR)激动剂和mRNA疗法(如ABCB4-LNP)在动物模型中展现出病因治愈潜力;中药活性成分(如芍药苷)通过调控FXR/胆汁盐输出泵(BSEP)通路减轻肝损伤。本文系统综述了婴幼儿胆汁淤积的病理机制分类及对应治疗策略,提出“精准诊断-靶向干预-微生物组调节”的多维治疗框架,为临床实践及新药研发提供新思路。
Keywords
胆汁淤积;病理机制;靶向治疗;基因编辑;中西医结合
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