肝纤维化程度及自身抗体表达对熊去氧胆酸单药治疗自身免疫性肝病重叠综合征患者临床疗效的影响

Impact of Fibrosis and Autoantibody on the Efficacy of Ursodeoxycholic Acid Monotherapy in Patients with Autoimmune Hepatitis and Primary Biliary Cirrhosis Overlap Syndrome

目的:肝纤维化程度及自身抗体表达对熊去氧胆酸单药治疗自身免疫性肝病重叠综合征患者临床疗效的影响。方法:回顾性收集2007年-2011年住院的20例做过肝穿活检的经熊去氧胆酸单药治疗达到满意效果的自身免疫性肝炎和原发性胆汁性肝硬化重叠综合征患者的临床资料。结果:20例患者中,12例患者(60%)的肝穿标本活检评估处于肝纤维化S3或S4期,其初诊时基线特征与肝纤维化处于S0-S2期的患者基线特征无统计学差异。此外,该20例患者的血清抗平滑肌抗体的阳性率较低(1/20)。结论:肝脏纤维化程度不会引起熊去氧胆酸治疗效果的下降。

To study the impact of fibrosis and autoantibody on the efficacy of ursodeoxycholic acid monotherapy in patients with autoimmune hepatitis and primary biliary cirrhosis overlap syndrome. Methods： The clinical data of 20 patients who had been diagnosed as autoimmune hepatitis and primary biliary cirrhosis overlap syndrome and undergone the liver biopsy were retrospectively collected. Results： A total of 20 patients were included. Of these patients, 12 had stage3 to stage4 fibrosis, who had similar clinical characteristics with the patients with stage0 to stage2 fibrosis. Additionally, the positive rate of serum anti-smooth muscle antibody was low（1/20）. Conclusion： The fibrosis stage may not lead to the decreasing efficacy of ursodeoxycholic acid.