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肾上腺皮质激素(简称激素)对肝脏有益的作用机制是:促进肝脏对氨基酸的摄取,强化蛋白合成酶,因而增加肝内蛋白的合成;增加肝糖原的合成;加强肝脏的解毒功能,促进胆汁的生成和排泄等,因而激素治疗肝病尤其是病毒性肝炎,曾是寄与很大希望的研究热点.然而随着病毒性肝炎病因和发病机制的阐明及应用双盲随机对照临床试验,对药物疗效作出客观的评价,发现长期皮质激素疗法,对乙肝病毒(HBV)不仅不能抑制反而使之活跃,促进肝硬变进展并出现一系列副作用.使病死率增加.目前,国际上有关肝病应用激素的适应证已达到共识,认为激素治疗病毒性肝炎利少弊多,一般不宜采用.但由于它对自身免疫性肝炎是有益的,治疗重型肝炎及淤胆型肝炎或许有一定价值,短程大剂量激素撤除疗法及短程皮质激素撤除后继用抗病毒方法能否增加疗效诸问题,国内认识尚未趋于一致,因而有必要对激素治疗病毒性肝炎的问题,进行全面的探讨.
Adrenocorticotropic hormone (Hormone) beneficial effect on the liver mechanism is: to promote liver uptake of amino acids, strengthen protein synthase, thereby increasing the synthesis of liver protein; increase the synthesis of hepatic glycogen; strengthen the liver’s detoxification function, and promote bile Of hormone production and excretion, and so hormone treatment of liver disease, especially viral hepatitis, has been sent with great hope of research hot spots.However, with the etiology and pathogenesis of viral hepatitis and the application of double-blind randomized controlled clinical trials, the drug efficacy Made an objective evaluation and found that long-term corticosteroid therapy for hepatitis B virus (HBV) not only can not inhibit but make it active, promote the progress of cirrhosis and a series of side effects, so that mortality increased.At present, the international application of hormones for liver disease Indications have reached consensus, that the hormone treatment of viral hepatitis, less benefit and less, generally unfit for use.But because it is beneficial to autoimmune hepatitis, the treatment of severe hepatitis and cholestatic hepatitis may have some value, short-term high-dose hormone Removal therapy and short-term withdrawal of corticosteroids followed by antiviral methods can increase the efficacy of the problem, the domestic understanding has not yet trend Consistent, it is necessary to question the hormone treatment of viral hepatitis, a comprehensive discussion.