含吡咯烷生物碱的中草药致肝窦阻塞综合征研究进展

doi:10.3969/j.issn.1672-5069.2014.04.033

Abstract

Abstract: Hepatic sinusoidal obstruction syndrome is rare clinically,but the incidence is recently increased. The clinical manifestations are mainly refractory ascites,jaundice and hepatomegaly.The main causes is the ingestion of pyrrolizidine alkaloids-containing herbs or plants. The early diagnosis is currently difficult. There is no specific therapy for patients with hepatic sinusoidal obstruction syndrome,except for symptomatic and supportive therapy. This review mainly discuss the mechanism,pathology,early diagnosis,and therapy of this entity.

Key words: Hepatic sinusoidal obstruction syndrome, Traditional Chinese medicine, Pyrrolizidine alkaloids

Zhang Junfei, Liu Bo, Chen Congxin. Increased challenge in traditional Chinese medicine containing pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(4): 445-455.

References

[1] Willmot FC.Robertson GW. Senecio disease,or cirrhosis of the liver due to seneeio poisoning.Lancet,1920,2:848-849.
[2] Hill KR,Rhodes K,Aub R,et al. Serous hepatosis:a pathogenesis of hepatic fibrosis in Jamaican children. Br Med J,1953,1（4802）:117-122.
[3] Deleve LD,Mccuskey RS,Wang X,et al.Characterization of a reproducible rat model of hepatic veno-occlusive disease.Hepatology,1999,29（6）：1779-1791.
[4] Brice K,Valerie B,Claire G,et al.Risk-adjusted monitoring of veno-occlusive disease following Bayesian individualization of busulfan dosage for bone marrow transplantation in paediatrics.
Pharmacoepidemiol Drug Saf,2008,17（2）:135-143.
[5] Dai N,Yu YC,Ren TH,et al. Gynuraroot induces hepatic veno -occlusive disease:a case report and review of the litera -ture.World J Gastroenterol,2007,13（10）:1628-1631.
[6] 徐静,王茂荣. 土三七导致肝小静脉闭塞综合征研究进展. 实用肝脏病杂志,2013,16（1）：94-96.
[7] Chen Z,Huo JR.Hepatic veno-occlusive disease associated with toxicity of pyrrolizidine alkaloids in herbal prearations. Neth J Med,2010,68（6）:252-260.
[8] Wang JY,Gao H. Tusanqi and hepatic sinusoidal obstruction syndrome. J Dig Dis,2014,15（3）:105-107.
[9] Li SL,Lin G,Fu PP,et al. Identification of five hepatotoxic pyrrolizidine alkaloids in acommonly used traditional Chinese medicinal herb Herba Senecionis scandentis（Qianliguang）.Rapid Commun Mass Spectrom,2008,22（4）:591-602.
[10] 王强,鲁重美,郭涛. 含吡咯烷生物碱的中草药与肝小静脉闭塞病. 临床消化病杂志,2008,20（1）：22-25.
[11] 粱爱华,叶祖光. 千里光属植物的毒性研究进展.中国中药杂志,2006,31（2）：93-97.
[12] 杨丽,霍继荣,朱洪怡,等. 3种药物诱导肝小静脉闭塞病小鼠模型的比较. 中华肝脏病杂志,2010,18（12）:944-945.
[13] 杨丽,霍继荣,欧大联.土三七致肝小静脉闭塞症临床与诊断. 肝脏,2009,14（5）：433-434.
[14] 肖玉洁,高向阳,韩正祥,等. 土三七致肝小静脉闭塞症1例及文献复习. 徐州医学院学报,2010,30（5）：334-335.
[15] DeLeve LD,Shulman HM,McDonald GB.Toxic injury to hepatic sinusoids:sinusoidal obstruction syndrome （veno-occlusive disease）.Semin Liver Dis,2002,22（l）:27-42.
[16] Helmy A. Review artiele:updates in the pathogenesis and therapy of hepatic sinusoidal obstruction syndrome.Alimenit Phannaeol Ther,2006,23:11-25.
[17] DeLeve LD,Wang XD,Kanel GC,et al. Decreased hepatic nitric oxide production contributes to the development of rat sinusoida lobstruction syndrome. Hepatology,2003,38:900-908.
[18] DeLeve LD,Ito Y,Bethea NW,et al. Embolization by sinusoidal lining cells obstructs the microcirculation in rats with sinusoidal obstruction syndrome. Am J Physiol Gastrointest Liver Physiol,2003,284:1045-1052.
[19] Richardson P,Guinan E. The pathology,diagnosis,and treatment of hepatic veno-occlusive disease:current status and novel approaches. Br J Haematol,1999,107（3）:485-493.
[20] DeLeve LD. Cellular target of cyclophosphamide toxicity in the murine liver:role of glutathione and site of metabolic activation.Hepatology,1996,24:830-837.
[21] DeLeve LD,Ito Y,Machen NW,et al.Embolization by sinusoidal lining cells causes the congestion of hepatic veno-occlusive disease.Gastroenterology,2000,118:A2345.
[22] Guan YS. A case report of hepatic veno-occlusive disease after ingesting dainties. World J Gastroenterol,2006,12（41）：6734-6735.
[23] Dharmananda S. Safety issues affecting herbs：pyrrolizidine alkaloids. http：http:www.Itmonline org/arts/pas.htm 2002.
[24] Maradei SC,Maiolino A,de Azevedo AM,et al.Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation. Blood,2009,114（6）：1137-1138.
[25] Gao H,LI N,Wang JY,et al.De?nitive diagnosis of hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids. J Digest Dis,2012,13（1）:33-39.
[26] 张菁菁,许敬华,李晓华. 肝小静脉闭塞综合征的超声特征分析. 实用医学杂志,2011,27（11）：2097-2098.
[27] 郭薇,时惠平,马晓璇,等. 肝小静脉闭塞病CT诊断. 中华临床医师杂志（电子版）,2012,6（13）：3722-3725.
[28] 尹丰.论螺旋CT与核磁共振成像对肝小静脉闭塞病的临床诊断意义. 医学信息,2013,26（2）:219-220.
[29] 胡智斌,张鹏,姚海泉. 肝小静脉闭塞病的CT和低场MRI诊断价值（5例报告并文献复习）. 中国CT和MRI杂志,2011,9（6）:11-12.
[30] Dumont CH,Lambert M,Van Beers BE.MR imaging findings in a patient with hepatic veno-occlusive disease.Acta Gastroenterol Bels,2004,67（2）：236-238.
[31] 陈华忠,邵辉,耿才正,等. 肝脏影像学检查在土三七引起的肝小静脉闭塞性疾病中的诊断价值. 临床肝胆病杂志,2012,5（28）:376-379.
[32] 陈洪谭,许国强,厉有名,等. 肝窦阻塞综合征8例临床分析. 中华内科杂志,2006,45（9）:734-737.
[33] 程捷尧,王泰龄,赵新颜,等. 280例肝穿刺标本质量调查分析. 中华肝脏病杂志,2014,3（22）：231-232.
[34] Zuckerman M,Steenkamp V,Stewart MJ. Hepatic veno-oclusive disease as a result of a traditional remedy：confirmation of toxic pyrrolizidine alkaloids as the cause,using an in vitro technique.J Clin Pathol,2002,55：676-679.
[35] 杨丽,霍继荣,朱洪怡,等. 丹参对土三七诱导小鼠肝小静脉闭塞病预防治疗效果的观察. 肝脏,2013,18（2）:105-107.
[36] WHO. Health and safety guide No 26：Pyrrolizidine alkaloidas.1989.hap：//www.inchem.org/documents/hsg/hsg/hsg026.htm.

Increased challenge in traditional Chinese medicine containing pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome

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