自身免疫型肝炎的临床诊断与治疗

Clinical Diagnosis and Treatment of Autoimmune Hepatitis

目的探讨自身免疫型肝炎(autoimmune hepatitis,AIH)患者的临床特点及泼尼松加环磷酰胺治疗的效果。方法 检测AIH组(16例)、其他慢性肝炎组(54例)、抗核抗体(ANA)阳性对照组(68例)和ANA阴性对照组(101例)血清中ANA、甘油三酯(TG)、胆固醇(TCHOL)、高/低密度脂蛋白(HDL/LDL)、总蛋白(TP)、球蛋白(GLB)、白蛋白(ALB)、乙型肝炎五项指标、丙型肝炎抗体、狼疮六项指标,并对16例AIH患者使用泼尼松加环磷酰胺的治疗效果进行跟踪,检测其TP、ALB、GLB、TG、TCHOL、谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆碱酯酶(CHE)和前白蛋白(PA)的变化。结果四组人群血清TP、ALB、GLB、TCHOL、HDL和LDL水平差异有统计学意义,治疗前后的AIH患者血清各指标水平差异有统计学意义。结论 AIH患者有其显著的临床诊断特点,可与其他慢性肝炎患者相鉴别,采用泼尼松加环磷酰胺的治疗有效。

Objective To explore the clinical features in patients with autoimmune hepatitis（AIH） and the curative effect of pornisone plus cyclophosphamide on these patients. Methods Serum ANA,TG,TCHOL,HDL,LDL,TP,GLB,ALB,ENA and the antigen and antibody of chronic liver diseases in AIH group（n=16）,other chronic liver diseases group（n=54）,control group with positive ANA（n=68）,and control group with negative ANA（n=101） were determined.The changes of serum TP,ALB,GLB,TG,TCHOL,ALT,AST,CHE,and PA in the patients of AIH group were determined before and after accepting the treatment of cyclophosphamide. Results There were statistically significant differences in the serum TP,ALB,GLB,TCHOL,HDL,and LDL among the patients of the four groups.There were statistically significant differences in the serum TP,ALB,GLB,TG,TCHOL,ALT,AST,CHE,and PA of the patients in AIH group before and after the treatment. Conclusion There are obvious clinical features to differentially diagnose AIH,and the treatment of pornisone plus cyclophosphamide is effective in AIH.