标题：他克莫司治疗类固醇抗性自身免疫性肝炎的临床疗效分析

      作者：黄志杰，许正锯，曾翠萍
    （中国人民解放军第180医院肝病中心，福建 泉州 362000）

      卷次： 2013年24卷21期

      【摘要】 目的 探讨他克莫司治疗类固醇抗性自身免疫性肝炎(AIH)的安全性和有效性。方法 选取2007
年1月至2012年12月间在我院接受他克莫司治疗的12例类固醇抗性AIH患者，分析其临床疗效。结果 经过
平均(25.1±9.3)个月的治疗后，谷丙转氨酶(ALT)和谷草转氨酶(AST)平均水平分别从(172.9±41.2) IU/L和
(131.8±31.3) IU/L降至(64.8±21.5) IU/L和(52.1±14.2) IU/L (P<0.05)。根据Metavir评分标准，所有患者的肝纤维
化和肝炎活动水平均有所改善(P<0.05)。所有患者均未出现严重并发症。结论 他克莫司是治疗类固醇抗性
AIH患者的有效手段，但仍需进一步研究明确其应用剂量和适用范围。

      【关键词】 自身免疫性肝炎；他克莫司；泼尼松

      【中图分类号】 R575.1 【文献标识码】 A 【文章编号】 1003—6350（2013）21—3143—03


Clinical efficacy of tacrolimus in the treatment of steroid refractory autoimmune hepatitis.
HUANG Zhi-jie, XU
Zheng-ju, ZENG Cui-ping. Liver Diseases Research Center, the 180th Hospital of PLA, Quanzhou 362000, Fujian, CHINA

【Abstract】 Objective To analyze the efficacy of tacrolimus in the treatment of steroid refractory autoim-
mune hepatitis (AIH). Methods The clinical data of 12 patients with steroid refractory AIH treated with tacrolimus
from Jan. 2007 to Dec. 2012 were studied retrospectively. The clinical efficacy was analyzed. Results The mean dura-
tion of treatment was (25.1±9.3) months. After treatment, the mean ALT and AST levels dropped from (172.9±41.2) IU/L
and (131.8±31.3) IU/L to (64.8±21.5) IU/L and (52.1±14.2) IU/L, respectively (P<0.05). All patients showed improve-
ment of the liver inflammatory activity, as determined by the Metavir score (P<0.05), while the degree of fibrosis tend-
ed to decrease (P<0.01). No serious complications was found. Conclusion Tacrolimus is effective for the treatment
of steroid refractory AIH, but the dosage and scope of application should be further determined.