培训课件-胆汁淤积症的诊断治疗.pptVIP

Steroid Receptor Action Cytoplasm HRE Nucleus Ligand SR SR SR SR SR mRNA Protein Cell specific Response 1 TF TF SR 2 J Hepatol 2007; 46 : 365–371 po 骨质疏松症的治疗 脂溶性维生素缺乏 Hepatology 2009; 40: 291 * 根据其发生部位的差异分为肝内胆汁淤积和肝外胆汁淤积，肝外胆汁淤积最常见的原因是机械性阻塞；肝内胆汁淤积的原因则更为复杂，包括感染性、药物性、自身免疫性、妊娠性等，但有时两者可有交叉，如原发性硬化性胆管炎（PSC）可同时有肝外和肝内部分的病变。 * In 1989, a panel of 12 European and American experts7 by consensus defined liver injury as an increase of more than twice the upper limit of the normal range in the levels of serum alanine aminotransferase or conjugated bilirubin, or a combined increase in the levels of aspartate aminotransferase,alkaline phosphatase, * total an alanine aminotransferase level of more than three times the upper limit of normal and a total bilirubin level of more than twice the upper limit be used as a combined test to define clinically significant abnormalities on liver tests, with further verification through the analysis of additional clinical data.8 Elevations in serum enzyme levels alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase were taken as indicators of liver injury, whereas increases in both total and conjugated bilirubin levels were measures of overall liver function bilirubin, * Panel C shows cholestatic injury due to trimethoprim–sulfamethoxazole in a 42-year-old woman. This portal tract shows a severely damaged bile duct surrounded by lymphocytes and eosinophils. The percentage of eosinophils in the peripheral blood reached 42 percent hematoxylin and eosin, 20 . In Panel D, a follow-up biopsy specimen from the same patient eight months later demonstrates the loss of bile ducts vanishing bile duct syndrome . This portal tract shows a normal artery and vein with no evident bile duct remaining Masson trichrome, ?60 . * 高度可能 8 可能 3-5 Excluded ≤0 可能性大 6-8 不可能Unlikely 1-2 * Herbalife is a product sold for promoting ‘wellness’ and weight reduction; the company reports sales of 1.6 billion $ in 60 countries /phoenix.z