[An interpretation of 2017 EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis].

Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease and may progress to liver fibrosis, liver cirrhosis, decompensated cirrhosis, and even end-stage liver disease without effective treatment. The diagnosis of PBC is mainly based on the biochemical parameters indicating cholestatic hepatitis and the presence of specific autoantibody in circulation. The goals of the treatment and management of PBC are to prevent the development of end-stage liver disease, to improve related clinical symptoms, and to improve patients' quality of life. Since PBC has relatively strong heterogeneity and the clinical manifestations and course of PBC can be diverse, it is necessary to provide long-term individualized treatment and follow-up for such patients. Here we provide an interpretation of the 2017 EASL Clinical Practice Guidelines for the diagnosis and management of patients with PBC, in order to better understand recent clinical research evidence and updated recommendations. In particular, we focus on the key points in the diagnosis, treatment, and follow-up strategies of PBC and emphasizing that timely and accurate risk stratification and proper clinical research enrollment may bring benefits to patients with refractory PBC.原发性胆汁性胆管炎（PBC）是一种慢性自身免疫性的胆汁淤积性疾病，如不给予有效治疗则可进展为肝纤维化、肝硬化及失代偿期，甚至终末期肝病。该疾病的诊断主要基于提示胆汁淤积性肝炎的生物化学指标以及循环中出现的特异性自身抗体。PBC治疗管理的主要目的是预防终末期肝病的发生，并改善疾病相关的临床症状，提高患者的生活质量。由于PBC是一种相对异质性较强的疾病，患者的临床表现和经过可有较大差异，因此给予患者长期的个体化治疗和随访是非常重要的。现对2017欧洲肝脏病学会发布的PBC诊治指南进行解读，以更好地理解新近出现的重要临床研究证据以及更新的推荐意见。尤其关注针对PBC的诊断、治疗及随访方面向临床提出的关键点，并强调及时准确地风险分层并将患者及时入组至恰当的临床研究可使难治性PBC患者受益。.