摘要
目的:描述I型自身免疫性肝炎(autoimmune hepatitis,AIH)的临床特点.方法:回顾性分析2000-01/2007-05天津医科大学总医院确诊的102例AIH患者的临床资料.结果:AIH患者102例,女性85例,男性17例,平均年龄59.73±13.46岁:症状:41.18%为慢性肝病表现,18.63%为急性肝炎表现,5.89%患者无症状:实验室检查:84.33%肝功能异常,80.00%γ-球蛋白或IgG异常,85.29%肝炎病毒标记物为阴性,50.67%血糖增高,74.51%ANA阳性。4.90%SMA阳性,7.84%AMA阳性:影像学:97.06%腹部超声异常,表现为肝脏质地不均或密度减低、肝硬化、肝癌、胆石、腹腔淋巴结肿大、腹腔积液等.37例患者予以治疗,其中缓解18例,不完全应答7例,复发5例,失败7例.结论:AIH炎临床表现复杂多样,但在免疫学、影像学和病理学等方面又具有特征性,这对临床诊治具有指导作用.
AIM： To describe the clinical features of type Ⅰ autoimmune hepatitis. METHODS： One hundred and two cases of autoimmune hepatitis admitted to Tianjin Medical University Hospital from January 2000 to May 2007 were retrospectively analyzed.
RESULTS： There were 85 females and 17 males, with a mean age of 59.73 4±13.46 years. Clinical manifestations of chronic liver disease were found in 41.18% patients, acute hepatitis manifestations in 18.63% patients, and no symptom in 5.89% patients. Laboratory tests showed that the percentage of abnormal liver function, gamma globulin or immunoglobulin G was 84.33% and 80%, respectively. Negative viral serology was found in 85.29% patients, hyperglycemia occurred in 50.67% patients. The positive rate of antinuclear antibody （ANA）, antismooth muscle antibody （SMA） and antimitochondrial antibody （AMA） was 74.51%, 4.90% and 7.84%, respectively. Abdominal ultrasound was abnormal in 97.06% patients. Ultrasonography revealed liver texture asymmetry or decreased density, hepatocirrhosis, hepatoma, bilestone, enlarged abdominal lymph nodes, ascites, etc. Of the 31 patients who received treatment, 18 had improvement in their symptoms, 7 incomplete response, 5 relapse and 7 treatment failure.
CONCLUSION： Autoimmune hepatitis has different manifestations. However, it has certain unique features in immunology, imageology, liver histology, which can be useful for its clinical diagnosis and treatment.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第3期322-325,共4页
World Chinese Journal of Digestology
