118例病原学指标阴性的肝病患者病因临床分析

Etiological study on 118 liver disease patients with seronegative viral hepatitis

目的了解肝炎病毒血清学标志阴性的肝病患者的病因。方法选择甲、乙、丙、丁、戊型病毒性肝炎血清学标志阴性的患者118例。对临床上诊断为病原学阴性的肝病患者血清,分别进行自身免疫性肝病抗体,ANA全套,FT3、FT4及TSH,血清Cu及铜蓝蛋白的检测。收集临床资料,分析结果。结果118例肝炎病毒血清学标志阴性的肝病患者中47例是病因不明的肝病,在病因不明的47例肝病患者中,14例患者的血清ANA等自身抗体中至少一种抗体为阳性。结论对病因不明的肝病有必要检测自身抗体,以排除自身免疫性肝病。

Aim To investigate the etiology of hepatitis patients who were seronegative for viral hepatitis A through E. Methods 118 patients with seronegative viral hepatitis in serum were selected. Autoantibodies including ANA, AMA, SMA et al, FT3, FT4,TSH, Cu and eeruloplasmin were detected with indirect immuno fluorescent assay in 118 chronic hepatic disease patients with non A-E hepatitis. Results Among these 118 patients, the etiological study included unexplained hepatitis （47） , autoimmune hepatic diseases （ 32 ） , drug hepatitis （ 10 ） , alcoholic liver disease （ 5 ） , drug induced liver diseases （ 10 ） , hepatobiliary surgical diseases induced liver diseases （ 7 ） , and other causes （9）. Meanwhile, 14 patients were found at least one of autoantibodies positive among the 47 patients with unexplained hepatitis. Conclusion It is necessary that autoantibodies should be examined on patients with hepatitis with unknown etiology for differential diagnosis of autoimmune liver disease.