原发性干燥综合征肝脏损害的特点(附52例分析)

Characteristic of hepatic lesion in primary sjogren syndrome (52 cases reports)

目的探讨原发性干燥综合征(primarysjogrensyndrome,PSS)肝损害中各项肝功能指标的异常情况及有关资料,总结其肝损害特点。方法对194例明确诊断的原发干燥综合征的肝损害进行分析。结果194例符合FOX分类标准的干燥综合征直接造成的肝损害共52例(26.8%),其中各项指标异常比例:谷草转氨酶(AST)33例(63.5%),谷丙转氨酶(ALT)26例(50.0%),碱性磷酸酶(ALP)35例(67.3%),γ-谷氨酰转肽酶(GGT)27例(51.9%),总胆红素(TBIL)18例(34.6%),直接胆红素(DBIL)23例(44.2%)。52例中行肝脏活检4例,病理结果:2例为慢性活动性肝炎,1例脂肪肝,1例不除外病毒性肝炎。结论原发性干燥综合征直接肝损害率26.8%,其中既有胆管炎的表现,也有以肝细胞损害为主者。首发症状表现不一,应引起重视。

[Objective] To analyze the abnormal levels of liver function of hepatic lesion in primat7 sjogren syndrome （pSS）, And to summarize the characteristic of hepatic lesion. [Method] Hepatic lesion in 194 cases who were definitely diagnosed pSS were analyzed, [Results] Hepatic lesion in 52 cases （26.8%） were direcdy made among 194 cases which were diagnosed pSS according to FOX classified criterion. The abnormal proportion of each level were aspartelte aminotransferase （AST） 33 cases （63.5%）, alanine aminotransferase（ALT） 26 cases （50,0%）, alkaline phosphatase （ALP） 35 cases （67.3%）, γ-glutamytransferase （GGT） 27 cases （51.9%）, Total bilirubin （TBIL） 18 cases （34,6%） and direct bilirubin （DBIL） 23 cases （44,2%）. 4 cases were made liver biopsy： 2 cases were chronic active hepatitis, 1 ease was fatty liver, and 1 case could not be excluded viral hepatitis. [Conclusion] The ratio of direct hepatic lesion in pSS is 28.4%. Some have grading of cholangitis and some of them have hepatocellular lesion. The first symptom is not identical which should be emphasized.