炎症性肠病合并自身免疫性肝病

孙颖昊; 钱家鸣

doi:10.12449/JCH250704

炎症性肠病合并自身免疫性肝病

DOI: 10.12449/JCH250704

孙颖昊,
钱家鸣^, ,

中国医学科学院北京协和医院消化内科，北京 100730

基金项目:

中国卫生行业科研专项基金 (201502005)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：孙颖昊负责设计论文框架，起草论文；钱家鸣负责对文章内容作批评性审阅，指导文章方向及最后定稿。

详细信息

通信作者:
钱家鸣， qianjiaming1957@126.com （ORCID： 0000-0001-6611-9475）

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出版历程
- 收稿日期: 2025-04-21
- 录用日期: 2025-05-30
- 出版日期: 2025-07-25

Inflammatory bowel disease comorbid with autoimmune liver disease

Yinghao SUN,
Jiaming QIAN^{,
,}

Department of Gastroenterology，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences，Beijing 100730，China

Research funding:

Health Research & Special Projects Grant of China (201502005)

More Information

Corresponding author: QIAN Jiaming， qianjiaming1957@126.com （ORCID： 0000-0001-6611-9475）

摘要

摘要: 炎症性肠病（IBD）与自身免疫性肝病（AILD）的共存现象在临床中日益受到关注。IBD患者中自身免疫性肝炎（AIH）、原发性硬化性胆管炎（PSC）以及AIH-PSC重叠综合征的患病率明显增高。IBD与AILD在遗传易感性、肠-肝轴调控、免疫失衡及胆汁酸代谢异常等方面存在显著的机制交叉。欧洲克罗恩和结肠炎组织指南推荐，对于疑似IBD且未经治疗的患者，应进行基本的肝功能检查，包括ALT、ALP、GGT和总血清胆红素检查，并在后续随访期间定期复查。IBD-AILD患者存在独特的临床特征，但目前缺乏针对共病的统一诊疗指南，治疗目标常需在肠道和肝脏间权衡，亟需跨学科协作和基于发病机制的联合疗法。未来研究应聚焦于肠-肝轴的动态调控网络，开发兼顾疗效和安全性的新型干预策略。
- 自身免疫疾病 /
- 炎症性肠病 /
- 治疗学
Abstract: The coexistence of inflammatory bowel disease （IBD） and autoimmune liver disease （AILD） has gained increasing attention in clinical practice， and there are significant increases in the prevalence rates of autoimmune hepatitis （AIH）， primary sclerosing cholangitis （PSC）， and AIH-PSC overlap syndrome among the patients with IBD. Several pathogenic mechanisms are shared between IBD and AILDs， including genetic susceptibility， dysregulation of the gut-liver axis， immune imbalance， and abnormal bile acid metabolism. The ECCO guidelines recommend that patients who are suspected of IBD and receive no treatment should undergo a series of liver function tests， including alanine aminotransferase， alkaline phosphatase， gamma-glutamyl transferase， and total serum bilirubin， as well as regular reexaminations during follow-up. While IBD-AILD patients have unique clinical features， there is still a lack of unified diagnosis and treatment guidelines for this comorbidity， and the selection of therapeutic goal often entails a careful balance between the intestinal tract and the liver， requiring interdisciplinary collaboration and combined therapies based on pathogenesis. Future research should focus on the dynamic regulatory networks of the gut-liver axis to develop innovative intervention strategies that ensure both efficacy and safety.
- Autoimmune Diseases /
- Inflammatory Bowel Disease /
- Therapeutics

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图 1 IBD与AILD发病机制的交叉及共性示意图

Figure 1. Schematic diagram of the overlap and commonalities in the pathogenesis of IBD and AILD

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