Intrahepatic cholestasis is a pathological condition in which the synthesis, secretion, and excretion of bile are blocked, and thus the bile does not flow normally into the duodenum and bloodstream. According to cytological damage site, it can be divided into hepatocellular cholestasis, biliary duct cell cholestasis and mixed cell cholestasis. The two kinds of pathophysiological models [ascending or upstream (damage begins with cholangiocytes and then extends to the hepatocytes) and descending or downstream (the damage starts from the liver cells and then extends to the bile duct cells)] has distinct features in the process of disease occurrence and development. This article mainly elaborates the "descending" pathophysiological model of cholestatic liver disease (hepatocytic damage progresses to biliary duct cell), and further explores its etiology, pathogenesis and treatment methods.
肝内胆汁淤积是指胆汁合成、分泌、排泄障碍，胆汁流不能正常流入十二指肠而进入血液循环的病理状态。根据细胞学损害的部位可分为肝细胞性胆汁淤积、胆管细胞性胆汁淤积及混合细胞性胆汁淤积。在疾病发生发展过程中，可分别呈现"上升"或"自下而上"，即损害首先从胆管上皮细胞胆管细胞开始然后累及到肝细胞，和"下降"或"自上而下"，即损害先从肝细胞开始然后累及到胆管细胞两种病理生理模式。现主要阐述胆汁淤积性肝病的"下降"病理生理模式即肝细胞性损害再进展到胆管细胞性的胆汁淤积，并探讨其病因、发病机制以及治疗方法。.
Keywords: Cholestasis; Diagnosis; Pathophysiology; Treatment.