自身免疫性肝病158例临床分析

Clinical analysis of 158 patients of autoimmune liver disease

目的分析比较自身免疫性肝病患者的临床表现、血清学等指标,以提高该病的诊断率以及对ALD的认识。方法回顾性分析笔者所在医院近3年来收治的自身免疫性肝病158例患者临床资料,其中自身免疫性肝炎(AIH)25例,原发性胆汁性胆硬化(PBC)110例,自身免疫性肝炎-原发性胆汁性肝硬化重叠综合征(AIH/PBC)23例患者的血清血指标的差异,并分析临床并发症及病理学特点。结果 AIH、AIH/PBC组中ALT、AST与PBC组比较差异有统计学意义,PBC、AIH/PBC组中GGT、ALP与AIH组比较,差异有统计学意义。AIH组中IgG与PBC组比较差异有统计学意义,PBC、AIH/PBC组中IgM与AIH组比较差异有统计学意义,上述指标比较差异均有统计学意义(P<0.05)。AIH组以ANA阳性为主,PBC组AMA、AMA-M2的阳性率较高而具有特异性,AIH/PBC兼有AIH及PBC的血清抗体特点。AIH、PBC、AIH/PBC最终均可进展为肝硬化失代偿期。结论 ALD临床表现多样化,起病隐匿,肝穿刺病理检查结合血清学指标阳性使诊断更为准确。

Objective To analyze and compare the physical characteristics of autoimmune liver disease （ALD） patient sufferers which include patient clinical manifestations and serology, aim to improve accuracy rate of this disease and learn more about ALD. Methods The clinical data of i58 cases of ALD patients were analyzed retrospectively, included 25 cases of autoimmune hepatitis, 110 cases of primary biliary cirrhosis and 23 cases of autoimmune hepatitis-primary biliary cirrhosis overlap syndrome,researched the blood serum differences of those patients ,and continued to analyze their clinical complications and pathological characteristic. Results There was statistical significance to compare two of ALT, AST.and PBC inthe group of AIH, AIH/PBC, The same with GGT, ALP and AIH in the group of PBC, AIH/PBC, IgG and PBC in the group of AIH, IgM and AIH in the group of PBC, AIH/PBC. The values of P in above index comparing were all 〈 O.05.In the group of AIH, main feature showed ANA was positive .In the group PBC, it showed a high rate that AMA, AMA-M2 was positive and both of them had its alone specificity. AIH/PBC had the same serum antibody characteristics with AIH and PBC. AIH, PBC and AIH/PBC all finally could be growing into decompensated cirrhosis. Conclusion The clinical manifestation of ALD show varieties, clinically its incidence is increasing gradually. It Can improve diagnostic accuracy using both liver biopsy and serological indexes when showing positive.