摘要
目的研究自身免疫性肝炎（ａｕｔｏｉｍｍｕｎｅ ｈｅｐａｔｉｔｉｓ， ＡＩＨ）的临床表现、肝活检病理学特征。方法回顾性总结１４例ＡＩＨ肝脏损害患者的临床表现及肝病理活检结果。结果ＡＩＨ主要影响女性，女：男为１３：１，年龄２８～６６岁；伴有迁延性丙氨酸转氨酶（ａｌａｎｉｎｅ ｔｒａｓａｍｉｎａｓｅ， ＡＬＴ）和天冬氨酸转氨酶（ａｓｐａｒｔａｔｅ ｔｒａｎｓａｍｉｎａｓｅ， ＡＳＴ）异常，高球蛋白、高γ球蛋白血症，存在多种自身抗体，伴发自身免疫性疾病，病理以慢性肝炎为特点，肝组织免疫荧光检查显示肝细胞膜或血窦区、汇管区有ＩｇＧ沉着。 ＡＩＨ的血清球蛋白（３３～６０ｇ／Ｌ）、γ球蛋白（２３．９％～６０．５％）、免疫球蛋白Ｇ（ＩｇＧ， ８．２～３９．０ｇ／Ｌ）及抗双链 ＤＮＡ（ｄｓ－ＤＮＡ， １．５～５８．０ ｎｇ／Ｌ）极显著高于正常人群的球蛋白、γ球蛋白、ＩｇＧ、 ｄｓ－ＤＮＡ（ ｔ值分别为 ９．７、 ９．３、 ６．２和 ３．５， Ｐ＜ ０．００１）。结论 ＡＩＨ肝脏损害严重，肝外病变多样，有多系统损害倾向，是一独立的自身免疫性疾病。
Objective To determine clinical manifestation and pathological changes in autoimmune hepatitis (AIH) by liver biopsy. Methods The clinical manifestation and pathological changes by liver biopsy in 14 AIH patients were investigated retrospectively. Results Clinically, AIH affects females with a females/male ratio of 13/l, the age range was 28-66 year; there was extended elevation of ALT and AST, hyperglobulinemia, hypergammaglobulinemia with predominant elevation of IgG and different kinds of antibodies. Patients usually had autoimmune diseases with pathological change of typical chronic hepatitis. The levels of globulin(33-60 g/L), gammaglobulin(23.9%~60.5%), IgG(8.2-39.0 g/L), ds-DNA(1.5~58.0 g/L) in AIH were signficantly higher than those of normal (t = 9.7, 9.3, 6.2, 3.5, P < 0.01). Conclusion AIH has severe liver impairment with many other symptoms due to multi--systemic damage out of liver. AIH is a distinct autoimmune disease.
出处
《中华肝脏病杂志》
CAS
CSCD
2000年第1期43-44,共2页
Chinese Journal of Hepatology
关键词
肝炎
自身免疫性
生物学标记
病理学
Hepatitis, autoimmunity
Bioclogical markers
Pathology, clinical
