自身免疫性肝炎56例临床分析

目的对自身免疫性肝炎患者的临床特点、免疫学以及病理学特点进行分析,以提高其诊断的准确率.方法：按照自身免疫性肝炎的诊断标准选择56例患者进行临床分析,肝功能指标与同时期的53例急性乙肝患者进行对比.结果：自身免疫性肝炎患者多见于女性（占80.36%）,多见亚型Ⅰ,发病平均年龄（50.18±7.98）岁,临床上多表现为黄疸、食欲不振、乏力等,临床表现不典型.16例合并有其他自身免疫性疾病,占28.57%.肝功能多表现为肝炎样异常,总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶显著高于正常值,其中γ-谷氨酰转肽酶显著升高,与急性乙肝患者的差异显著.自身抗体检测显示患者免疫球蛋白显著升高,有52例自身抗体呈阳性,以抗核抗体阳性率最高,其次是抗平滑肌抗体、抗线粒体抗体等.结论：可根据患者的临床表现、肝功能检测、免疫性检测的特点来提高自身免疫性肝病诊断的准确率.

Objectivethe clinical characteristics of patients with autoimmune hepatitis, immunology and pathology characteristics is analyzed, in order to improve its diagnostic accuracy. Methods：according to the diagnostic standard of autoimmune hepatitis on clinical analysis of 56 patients with liver function index and period of 53 cases of acute hepatitis b patients were compared. Results：in patients with autoimmune hepatitis in women （80.36%）, rare subtypes Ⅰ, mean age 50.18 ＋ / - 7.98 years old, more clinically characterized by jaundice, loss of appetite, fatigue, etc., atypical clinical manifestations. 16 cases with other autoimmune diseases, accounting for 28.57%. Abnormal liver function more performance for hepatitis samples, total bilirubin, alanine aminotransferase, aspartate aminotransferase is significantly higher than normal value, the gamma GGTP （gamma glutamyl transpeptidase） significantly increased, and the significant difference in patients with acute hepatitis b. Autoantibodies detection showed a significant rise in patients with immune globulin, 52 cases of autoantibody positive, antinuclear antibody positive rate is highest, followed by anti smooth muscle antibodies, antimitochondrial antibodies, etc. Conclusion：according to the patient＇s clinical manifestation, liver function test, the characteristics of the immunity test to improve the accuracy of autoimmune liver disease diagnosis.