药物性肝损伤患者检测自身免疫性抗体的临床意义

Clinical significance of detecting autoimmune antibodies in patients with drug-induced liver injury

目的:探讨药物性肝损伤患者检测自身免疫性抗体的临床意义。方法:回顾性分析我院60例药物性肝损伤患者,根据肝损伤缓急情况分为急性组(n=32)和慢性组(n=28)。收集并分析两组患者肝功能、自身免疫性抗体及转归情况。结果:两组肝功能指标水平差异均无统计学意义(P>0.05);慢性组自身免疫性抗体阳性率高于急性组(P<0.05);急性组抗核抗体滴度为1:100有11例,1:320有5例;慢性组抗核抗体滴度为1:100有7例,1:320有6例,1:1000有8例。所有患者经对症支持治疗,均康复出院。结论:急、慢性药物性肝损伤患者肝功能指标水平差异不大,慢性患者可检测出滴度较高的自身免疫性抗体,但需与自身免疫性肝病做好鉴别诊断。

Objective: To explore the clinical significance of detecting autoimmune antibodies in patients with druginduced liver injury.Methods: Sixty patients with drug-induced liver injury in our hospital were retrospectively analyzed.The patients were divided into an acute group(n=32) and a chronic group(n=28).The data of their liver function, autoimmune antibodies, and outcome were collected and analyzed.Results: There were no significant differences in liver function index between the two groups(P>0.05);The positive rate of autoimmune antibody in the chronic group was higher than that in the acute group(P<0.05).The titer of anti-nuclear antibody was 1:100 with 11 cases and 1:320 with 5 cases in the acute group and 1:100 with 7 cases, 1:320 with 6 cases and 1:1 000 with 8 cases in the chronic group.All the patients were recovered and discharged after symptomatic supportive treatment.Conclusion: There are no significant differences in liver function indexes between the patients with acute or chronic drug-induced liver injury.High-titer autoimmune antibody can be detected in patients with chronic drug-induced liver injury, however they need to be differentiated from autoimmune liver disease.