药物性肝损伤与自身免疫性肝炎的鉴别诊断与治疗策略

Differential diagnosis of drug-induced liver injury and autoimmune hepatitis and related therapeutic strategies

药物性肝损伤(DILI)与自身免疫性肝炎(AIH)的临床及组织学表现存在较多相似点,给临床医师的鉴别诊断带来困难。通过分别阐述DILI与AIH的关系、临床表现及组织学的异同点,帮助临床医师更好地鉴别DILI与AIH。总结了DILI与AIH治疗方案的选择,尤其着重介绍了在两者鉴别存在困难时,如何根据患者的病情选择不同的治疗策略,最终明确诊断。

Drug-induced liver injury（DILI） and autoimmune hepatitis（AIH） have many similar clinical and histological manifestations,which brings difficulties to clinicians in differential diagnosis. This article elaborates on the association between DILI and AIH and their similarities and differences in clinical and histological manifestations,in order to help clinicians with the differential diagnosis of DILI and AIH.This article reviews the selection of therapeutic regimens for DILI and AIH and introduces how to select therapeutic strategies based on patient conditions and make a definite diagnosis when there are difficulties in differential diagnosis.