课件：病毒性肝炎治疗之困惑如何评价抗炎保肝价值？.pptx

;肝脏炎症有何意义？;肝脏免疫反应的独特性能;Natural History of Chronic Hepatitis B;Cumulative Incidence of Cirrhosis by Serum HBV DNA Level at Study Entry;REVEAL: Relationship Between Baseline HBV DNA and Cirrhosis;Cumulative Incidence of HCC by Serum HBV DNA Level at Study Entry;Successful Hepatitis B Treatment Reduces Clinical Endpoints; 90%Hepatocellular carcinoma (HCC) patients had serious inflammation and fibrosis;抗病毒治疗是否能解决所有问题？;HBeAg阳性慢乙肝患者治疗一年ALT的复常率;HBsAg/HBeAg血清状态和ALT校正HCC的风险比;ALT居高不下是CHB严重不良预后的重要危险因素之一;CHB病人经抗病毒治疗后ALT复常率常不理想;15;抗病毒治疗后病毒耐药导致肝脏炎症加重;80;延长NUCs抗病毒时间，肝纤维化改善率仍不理想;不规范停药导致肝炎复发;抗病毒治疗并不能解决所有问题;No inflammation，no liver disease？;肝脏炎症如何发生？;Inflammasome activating pathways ;Fig. Cell-specific inflammasome expression in the liver.;Fig. Triggers of inflammasome activation in liver diseases.;问题;肝脏炎症是各型慢性肝炎及肝硬化共同病理基础;长期抗炎保肝可以降低肝硬化和肝癌的发生，延缓肝硬化和肝癌发生;α-甘草酸抗炎作用强，快速改善肝脏功能;甘草酸治疗可协同增效抗病毒治疗效果;抗炎保肝药物治疗增加CHB患者抗病毒治疗的疗效及依从性;问题;背 景;《肝脏炎症及其防治专家共识》推动;Prevention and Management of Liver Inflammation: an Expert Consensus in China;A variety of evidences suggest that liver inflammation can be found in the liver diseases induced by almost all causes(Ⅰ) In China，the number of patients with viral hepatitis are currently staying high, and the incidences of drug-induced hepatitis, alcoholic, nonalcoholic steatohepatitis and autoimmune liver diseases are increasing obviously. (Ⅰ) The main pathology and pathogenesis in liver disease progression includes liver inflammation, fibrosis, cirrhosis and liver failure, etc.(Ⅰ) All-round accessorial tests can be used to evaluate liver damage degree of inflammatory, with the elevated serum ALT as the most commonly used indicator. However, it is so far controversial on the ULN of the serum ALT, among which ages might have biggest influence on its level. (Ⅰ) Although anti-inflammatory therapy is a part of comprehensive treatments for liver inflammation, it cannot replace of antiviral therapy on the etiologies, etc. Conversely, etiological treatment such as anti