实用肝脏病杂志 ›› 2024, Vol. 27 ›› Issue (3): 477-480.doi: 10.3969/j.issn.1672-5069.2024.03.040

• 综述 • 上一篇    

肝豆状核变性治疗现状与展望*

徐旭, 施漪雯 综述, 范建高 审校   

  1. 200092 上海市 上海交通大学医学院附属新华医院消化内科
  • 收稿日期:2023-11-10 出版日期:2024-05-10 发布日期:2024-06-11
  • 通讯作者: 范建高,E-mail:fanjiangao@xinhuamed.com.cn
  • 作者简介:徐旭,女,25岁,硕士研究生。E-mail: xuxu199895 @163.com
  • 基金资助:
    * “十四五”国家重点研发计划重点专项(编号:2021YFC2700802)

Treatment of hepatolenticular degeneration:Status and prospective

Xu Xu, Shi Yiwen, Fan Jiangao   

  1. Department of Gastroenterology, Xinhua Hospital, JiaoTong University, Shanghai 200092, China
  • Received:2023-11-10 Online:2024-05-10 Published:2024-06-11

摘要: 肝豆状核变性(HLD)是由于ATP7B基因突变导致细胞内铜转运功能障碍,从而引起铜过度蓄积在各器官而导致的疾病。早期诊断和治疗可以改善HLD患者的预后,减少残疾和早期死亡。目前,治疗方法主要包括低铜饮食、药物治疗和肝移植。但低铜饮食并不能显著减少肠道上皮细胞铜吸收量且过度限制会造成正常组织细胞营养吸收障碍。现有的药物治疗方案经常面临患者依从性差、神经系统症状恶化等问题。肝移植的开展常因供体器官的短缺和终身免疫抑制治疗的需求而受限,而新疗法,如新型药物制剂、细胞治疗、基因治疗给HLD患者带来了新希望。

关键词: 肝豆状核变性, 低铜饮食, 药物治疗, 肝移植, 基因治疗

Abstract: The hepatolenticular degeneration (HLD), also known as Wilson's disease, is an entity of disordered copper metabolism caused by ATP7B gene mutation, which leads to intracellular copper transport dysfunction and excessive accumulation of copper in various organs. The early diagnosis and treatment can improve the prognosis of patients with HLD and reduce disability and early death. The current treatments include a diet with low copper, medical intervention and liver transplantation. However, the low copper diet could not significantly reduce the amount of copper absorption in intestinal epithelial cells, and excessive restriction of it will cause nutrient absorption disorders in normal tissue cells. The present treatment regimens often face problems such as poor adherence and worsening neurological symptoms. The application of liver transplantation is often limited by the shortage of donor organs and the need for lifelong immunosuppression. The new therapies, such as new medicine preparations, cell and gene therapy have brought new hopes for patients with HLD.

Key words: Hepatolenticular degeneration, Low copper diet, Medication, Liver transplantation, Gene therapy