中国药物警戒 ›› 2022, Vol. 19 ›› Issue (10): 1149-1153.
DOI: 10.19803/j.1672-8629.20210604
孙雪林, 胡欣, 张亚同
收稿日期:
2021-06-19
出版日期:
2022-10-15
发布日期:
2022-10-17
作者简介:
孙雪林,女,博士,副主任药师,临床药学。
基金资助:
SUN Xuelin, HU Xin, ZHANG Yatong
Received:
2021-06-19
Online:
2022-10-15
Published:
2022-10-17
摘要: 熊去氧胆酸(ursodeoxycholic acid,UDCA)是由胆固醇衍生而来的天然亲水性胆汁酸,可通过抑制胆固醇在肠道内的重吸收和降低胆固醇向胆汁中的分泌,从而降低胆固醇的饱和度,临床上主要用于胆石症、胆汁淤积性肝病、胆汁反流性胃炎、原发性硬化性胆管炎等的治疗。本文从UDCA临床应用和指南推荐角度,总结其在疾病的应用、不良反应和药学监护等,为UDCA的临床合理应用提供参考。
中图分类号:
孙雪林, 胡欣, 张亚同. 熊去氧胆酸的临床应用进展[J]. 中国药物警戒, 2022, 19(10): 1149-1153.
SUN Xuelin, HU Xin, ZHANG Yatong. Clinical application of ursodeoxycholic acid[J]. Chinese Journal of Pharmacovigilance, 2022, 19(10): 1149-1153.
[1] AERTS R, PENNINCKX F.The burden of gallstone disease in Europe[J]. Aliment Pharmacol Ther, 2003, 18(Suppl 3): 49-53. [2] YOU GM.Overview of research on ursodeoxycholic acid[J]. Journal of Pharmaceutical Research(药学研究),2021, 40(3):199-202. [3] DataBase Yaozhi. Ursodeoxycholic Acid Capsules [EB/OL].(2013-06-28)[2022-08-04]. https://db.yaozh.com/directory/6933233860000008.html. [4] PEERY AF, CROCKETT SD, BARRITT AS, et al.Burden of Gastrointestinal, liver, and pancreatic diseases in the United States[J]. Gastroenterology, 2015, 149(7): 1731-1741. [5] GUARINO MP, CONG P, CICALA M, et al.Ursodeoxycholic acid improves muscle contractility and inflammation in symptomatic gallbladders with cholesterol gallstones[J]. Gut, 2007, 56(6): 815-820. [6] Guarino MP, Cocca S, Altomare A, et al.Ursodeoxycholic acid therapy in gallbladder disease, a story not yet completed[J]. World J Gastroenterol, 2013, 19(31): 5029-5034. [7] RUBIN RA, KOWALSKI TE, KHANDELWAL M, et al.Ursodiol for hepatobiliary disorders[J]. Ann Intern Med, 1994, 121(3): 207-218. [8] NONE. clinical updates in women's health care summary: liver disease: reproductive considerations[J]. Obstet Gynecol, 2017, 129(1): 236. [9] GEENES V, WILLIAMSON C.Intrahepatic cholestasis of pregnancy[J]. World J Gastroenterol, 2009, 15(17): 2049-2066. [10] KREMER AE, OUDE ELFERINK RP, BEUERS U.Pathophysiology and current management of pruritus in liver disease[J]. Clin Res Hepatol Gastroenterol, 2011, 35(2): 89-97. [11] BICOCCA MJ, SPERLING JD, CHAUHAN SP.Intrahepatic cholestasis of pregnancy: review of six national and regional guidelines[J]. Eur J Obstet Gynecol Reprod Biol, 2018, 231: 180-187. [12] EATON JE, TALWALKAR JA, LAZARIDIS KN, et al.Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management[J]. Gastroenterology, 2013, 145(3): 521-536. [13] PAUMGARTNER G, BEUERS U.Ursodeoxycholic acid in cholestatic liver disease: mechanisms of action and therapeutic use revisited[J]. Hepatology, 2002, 36(3): 525-531. [14] CHARATCHAROENWITTHAYA P, ANGULO P, ENDERS FB, et al.Impact of inflammatory bowel disease and ursodeoxycholic acid therapy on small-duct primary sclerosing cholangitis[J]. Hepatology, 2008, 47(1): 133-142. [15] DE MARIA N, COLANTONI A, ROSENBLOOM E, et al.Ursodeoxycholic acid does not improve the clinical course of primary sclerosing cholangitis over a 2-year period[J]. Hepatogastroenterology, 1996, 43(12): 1472-1479. [16] SHI J, LI Z, ZENG X, et al.Ursodeoxycholic acid in primary sclerosing cholangitis: meta-analysis of randomized controlled trials[J]. Hepatol Res, 2009, 39(9): 865-873. [17] KELLY DA.Liver complications of pediatric parenteral nutrition-epidemiology[J]. Nutrition, 1998, 14(1): 153-157. [18] ARSLANOGLU S, MORO GE, TAUSCHEL HD, et al.Ursodeoxycholic acid treatment in preterm infants: a pilot study for the prevention of cholestasis associated with total parenteral nutrition[J]. J Pediatr Gastroenterol Nutr, 2008, 46(2): 228-231. [19] CHEN CY, TSAO PN, CHEN HL, et al.Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition-associated cholestasis[J]. J Pediatr, 2004, 145(3): 317-321. [20] SAN LUIS VA, BTAICHE IF.Ursodiol in patients with parenteral nutrition-associated cholestasis[J]. Ann Pharmacother, 2007, 41(11): 1867-1872. [21] RANGEL SJ, CALKINS CM, COWLES RA, et al.Parenteral nutrition-associated cholestasis: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review[J]. J Pediatr Surg, 2012, 47(1): 225-240. [22] BEUERS U, GERSHWIN ME, GISH RG, et al.Changing nomenclature for PBC: From ‘cirrhosis' to ‘cholangitis'[J]. Hepatology, 2015, 62(5): 1620-1622. [23] CORPECHOT C, ABENAVOLI L, RABAHI N, et al.Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis[J]. Hepatology, 2008, 48(3): 871-877. [24] LINDOR KD, BOWLUS CL, BOYER J, et al.Primary Biliary cholangitis: 2018 practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology, 2019, 69(1): 394-419. [25] CHEN XM, LARUSSO NF.Cryptosporidiosis and the pathogenesis of AIDS-cholangiopathy[J]. Semin Liver Dis, 2002, 22(3): 277-289. [26] CASTIELLA A, IRIBARREN JA, LÓPEZ P, et al. Ursodeoxycholic acid in the treatment of AIDS-associated cholangiopathy[J]. Am J Med, 1997, 103(2): 170-171. [27] DEBRAY D, KELLY D, HOUWEN R,et al.Best practice guidance for the diagnosis and management of cystic fibrosis-associated liver disease[J]. J Cyst Fibros, 2011,10(Suppl 2): S29-S36. [28] SOKOL RJ, DURIE PR.Recommendations for management of liver and biliary tract disease in cystic fibrosis[J]. J Pediatr Gastroenterol Nutr, 1999, 28(Suppl 1): S1-S13. [29] COLOMBO C.Liver disease in cystic fibrosis[J]. Curr Opin Pulm Med, 2007, 13(6): 529-536. [30] ZHNG H, HAN J, ZHANG XL.An excerpt of the Japanese society of gastroenterology of evidence-based clinical practice guidelines for liver cirrhosis(2015)[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2016, 32(9):1659-1663. [31] YE JF, WU JM, ZHANG BQ, et al.Recommendation for EASL clinical practice guidelines on the prevention, diagnosis, and therapy of gallstones(2016)[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2016, 32(8): 1446-1449. [32] SUN CY, MA X.An excerpt of EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis(2017)[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2017, 33(10): 1888-1894. [33] LI QQ, ZHOU XM, QI XS, et al.Recommendations for the British Society of Gastroenterology/UK-PBC primary biliary cholangtitis treatment and management guidelines(2018)[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2018, 34(6): 1191-1192. [34] LU LG, TIAN LY, XU MY, et al, European society of liver disease clinical practice Guidelines: treatment of cholestatic liver disease (3)[J]. Chinese Hepatology(肝脏), 2009, 14(6): 476-478. [35] LU LG, TIAN LY, XU MY, et al, European Society of Liver Disease clinical Practice Guidelines: Treatment of cholestatic liver disease (2)[J]. Chinese Hepatology(肝脏), 2010, 15(1): 44-48. [36] YAN H, NIU JQ.ACG clinical guidelines: primary sclerosing cholangtisi(2015)-an excerpt of recommendations[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2015, 31(8): 1198-1201. [37] YU YC, HOU JL.ACG clinical guidelines(2016): liver disease and pregnancy[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2016, 32(4): 619-627. [38] SUN XD, YE JF, FU Y, et al.American academy of liver diseases and american society of transplantation 2012 practice guidelines: long-term management after successful liver transplantation in adults[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2013, 29(6): 481-495. [39] TAN YP.AGA Institute medical position panel on diagnosis and management of colorecatal neoplasia in inflammatory bowel disease[J]. Chin J Gastrointest Surg(中华胃肠外科杂志), 2010, 13(9): 711-712. [40] Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, et al. Expert consensus on diagnosis and Treatment of Primary sclerosing cholangitis (2015)[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2016, 32(1): 23-31. [41] Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, et al. Consensus on diagnosis and treatment of Primary Biliary cirrhosis (ALSO known as Primary biliary cholangitis) (2015)[J]. Chinese Journal of Hepatology|Chin J Hepatol(中华肝脏病杂志), 2016, 24(1): 5-13. [42] Committee of Experts of Diagnosis and Treatment of Intrahepatic Cholestasis. Intrahepatic cholestasis diagnosis and treatment expert consensus[J]. Chin J Clin Infect Dis(中华临床感染病杂志), 2015, 8(5): 402-406. [43] Expert Committee on the 2015 Update of Expert Consensus on the Diagnosis and Treatment of Cholestatic Liver Disease. Expert consensus on the diagnosis and treatment of cholestatic liver disease: an update in 2015 the 2015 Update of Expert Consensus on the Diagnosis and Treatment of Cholestatic Liver Disease. Expert consensus on the diagnosis and treatment of cholestatic liver disease: an update in 2015[J]. Journal of Clinical Hepatol(临床肝胆病杂志), 2015, 31(10): 1563-1574. [44] Department of Obstetrics and Gynecology, Chinese Medical Association. Guidelines for the diagnosis and treatment of intrahepatic cholestasis of pregnancy (2015)[J]. Chin J Obstet Gynecol(中华妇产科杂志), 2015, 50(7): 481-485. [45] LI JX, CHEN Y, LIANG J.Consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of cholelithiasis (2017)[J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion(中国中西医结合消化杂志), 2018, 26(2): 132-138. [46] CHEN YB, HUANG WM, HUANG L, et al.Expert suggestions on standardized medicationguidance for neonatal jaundice[J]. Chin Med Herald(中国医药导报), 2019, 16(27): 105-110. [47] Editorial Board of Chinese Journal of Digestion, Cooperation Group of Hepatobiliary Diseases of Chinese Society of Gastroenterology. Consensus on diagnosis and treatment of chronic cholecystitis and gallstones in China(2018)[J]. Chin J Dig(中华消化杂志), 2019, 35(6): 1231-1236. [48] Neonatal Surgery Group, Pediatric Hepatobiliary Surgery Group, Pediatric Pediatric Surgery Branch, et al. Diagnosis and treatment of biliary atresia in mainland China (expert consensus)[J]. Chin J Pediatr Surg(中华小儿外科杂志), 2013, 34(9): 700-705. [49] HU ZC, NI P, FAN L, et al.Past hepatitis B virus infection was not associated with poorer response or the UK-PBC risk score in ursodeoxycholic acid-treated patients with primary biliary cirrhosis[J]. Eur J Gastroenterol Hepatol, 2019, 31(2): 277. [50] ZHOU XL, FU JF.Expert consensus on the diagnosis and treatment of nonalcoholic fatty disease in children[J]. Chinese Journal of Practical Pediatrics(中国实用儿科杂志), 2018, 33(7): 487-492. [51] Digestive Diseases Professional Committee of Chinese Association of Integrated Traditional and Western Medicine. Consensus on diagnosis and treatment of cirrhotic ascites with integrated Traditional Chinese and Western medicine[J]. Chinese Journal of Integrated Traditional and Western Medicine(中国中西医结合杂志), 2011, 31(9): 1171-1174. [52] XIAO XH, LI XH, ZHU Y.Guidelines for diagnosis and treatment of herb-induced liver injury[J]. China Journal of Chinese Materia Mdica(中国中药杂志), 2016, 41(7): 1165-1172. [53] Chinese Society of Infectious Diseases, Chinese Medical Association. Expert consensus on diagnosis and treatment of end-stage liver disease with infection (2021 edition)[J]. Chin J Hepatol(中华肝脏病杂志), 2022, 30(2): 147-158. [54] CHEN XP, MAO YL, QIU YD, et al.Expert consensus on perioperative management of hepatectomy[J]. Chinese Journal of Practical Surgery(中国实用外科杂志), 2017, 37(5): 525-530. [55] WANG YM, YU YC.Liver inflammation and its prevention and cure expert consensus[J]. Chin J Infect(中华肝脏病杂志), 2014, 22(2): 94-103. [56] Tuberculosis Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of antituberculous drug-induced liver injury (2019 Edition)[J]. Chinese Journal of Tuberculosis and Respiratory Diseases(中华结核和呼吸杂志), 2019, 42(5): 343-356. [57] Hepatobiliary Diseases Association of Gastroenterology Society of Chinese Medical Association. Recommendations on diagnosis and treatment of Acute Drug-induced Liver Injury (draft)[J]. Chin J Dig(中华消化杂志), 2007, 27(11): 765-767. [58] Chinese Lapatinib Adverse Response Management Consensus Expert Group. Consensus on adverse reaction management of Lapatinib[J]. Oncology Process(癌症进展), 2019, 17(22): 2605-2611. [59] Chinese Society of Hepatology Chinese Medical Association, Chinese Society of Gastroenterology Chinese Medical Association, Chinese Society of Infectious Diseases, et alConsensus on diagnosis and treatment of hepatic fibrosis in 2019[J]. Chin J Hepatol(中华肝脏病杂志), 2019, 27(9): 657-667. [60] Chinese Society of Hepatology, Chinese Medical Association, Chinese Society of Gastroenterology, et al. Consensus on the diagnosis and management of autoimmune hepatitis(2015)[J]. Chin J Hepatol(中华肝脏病杂志), 2016, 24(1): 23-35. [61] SHI JP, FAN JG.Expert recommendation on standardized diagnosis and treatment for fatty liver disease(2019 revised edition)[J]. Journal of Practical Hepatology(实用肝脏病杂志), 2019, 22(6): 787-792. [62] YOU GM.Overview of research on ursodeoxycholic acid[J]. Journal of Pharmaceutical Research(药学研究), 2021, 40(3): 199-202. [63] FDA. FDA-Approved Drugs. URSO 250[EB/OL].(2013-06-14)[2022-08-04]. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020675. [64] SHI YH.Ursodeoxycholic acid and interstitial pneumonia[J]. Adverse Drug Reaction Journal(药物不良反应杂志), 2001, 3(4): 266-266. |
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