摘要
目的比较自身免疫性肝炎(AIH),原发性胆汁性肝硬化(PBC),以及AIH-PBC重叠综合征,与慢性丙型肝炎(chronic hepatitis C,CHC)的临床表现、生化、免疫特点、治疗等,以助于诊治自身免疫性肝病。方法对74例AIH患者、21例PBC-AIH重叠综合征患者、48例PBC患者的临床及实验室检查资料进行回顾性分析,并与47例CHC患者进行对比。结果各组患者均有不同程度纳差、乏力等不典型临床症状,肝脏生化指标异常,自身免疫性肝病中免疫学指标可见不同程度异常,丙型肝炎的免疫学指标也可见部分异常。AIH组ALT、AST升高较明显,ANA阳性为主。肝活体组织检查:界面性肝炎常见,无淤胆;PBC组ALP、GGT升高较明显,M2阳性为主,肝活体组织检查淤胆及肝硬化常见。AIH-PBC兼具有两者特点。使用糖皮质激素,UDCA等治疗,大多可获得住院期间缓解。结论生化、免疫、肝活体组织检查等检测对自身免疫性肝病具有重要诊断意义,糖皮质激素,熊去氧胆酸等药物治疗有效。
Objective To analyze and compare the clinical ,biochemical ,immunological features of AIH,PBC ,PBC-AIH overlap syndrome and CHC. Methods Clinical and laboratory data of 143 patients with autoimmune liver diseases （74 cases with AIH,21 cases with PBC-AIH overlap syndrome, 48 cases with PBC）were retrospectively analyzed,and compared with CHC at the same time. Results The patients were manifested with anorexia, fatigue and so on ,and the liver function exhibited various abnormal. Symptoms were not typical. The immune function test showed abnormal in most of patients with autoimmune liver diseases and some patients with CHC. ALT and AST levels were markedly increased in patients with AIH, whereas ALP and GGT levels were significantly increased in patients with PBC. There was significant difference of autoantibodies between AIH and PBC. Most cases showed positive ANA in patients with AIH, but most cases showed positive AMA in patients with PBC. About liver biopsy, inflammation at the interface was common in AIH, whereas cholestasis and cirrhosis was more common in PBC. PBC-AIH overlap syndrome possess the features from both of AIH and PBC. UDCA and glucocorticosteroid therapy could attain a significant biochemical and clinical improvement in most patients within the duration of hospital stay. Conclusion The patients with autoimmune liver diseases could be diagnosed by investigation of clinical features and detection of autoantibodies,liver function and liver biopsy.UDCA and glucocorticosteroid are effective and safe in patients with AIH,PBC or AIH-PBC overlap syndrome.
出处
《药品评价》
CAS
2007年第5期347-351,共5页
Drug Evaluation
关键词
肝炎
自身免疫性
肝硬化
胆汁性
肝炎
丙型
慢性
综合分析
Hepatitis, autoimmune
Liver cirrhosis, biliary
Hepatitis C, chronic
Meta-analysis
