自身免疫性肝炎治疗后应答不佳的影响因素分析

Analysis of influencing factors of poor response on treatment of autoimmune hepatitis

目的探讨自身免疫性肝炎(AIH)治疗后应答不佳的影响因素。方法回顾性分析常州市第三人民医院2012年1月至2019年10月收治的78例AIH患者的临床资料,依据治疗后应答情况分为应答良好组54例与应答不佳组24例。比较两组性别、年龄、临床症状(乏力、恶心、黄疸、纳差、腹痛)、血清抗核抗体(ANA)、抗线粒体抗体(AMA)、ALT、AST、总胆红素(TBil)、碱性磷酸酶(ALP)间的差异,多因素logistic回归分析AIH治疗后应答不佳的危险因素。结果应答不佳组患者存在乏力、恶心、黄疸患者,ANA、AMA抗体阳性患者占比分别为75.00%、79.16%、83.33%、79.17%、75.00%,显著高于应答良好组的25.00%、20.83%、16.67%、20.83%、25.00%(均P<0.05)。通过多因素Logistic回归分析证实,AIH患者存在乏力、恶心、黄疸症状,ALP高表达是治疗后应答不佳的危险因素,(均P<0.05)。结论AIH应答不佳患者多存在乏力、恶心、黄疸症状,且血清ALP呈现出高表达,均为治疗后应答不佳的危险因素。

Objective To explore the factors influencing poor response on treatment of autoimmune hepatitis(AIH).Methods The clinical data of 78 patients with AIH admitted to our hospital from January 2012 to October 2019 were analyzed retrospectively.All patients were divided into good response group(n=54)and poor response group(n=24)according to the response after treatment.To compare the differences between the two groups in basic data(gender,age),clinical symptoms(whether there is fatigue,nausea,jaundice,poor appetite,abdominal pain),serum indexes(ANA,AMA,alt,AST,TBIL,ALP),we will find that there are different information lines and using multi factor logistic.C regression analysis to explore the risk factors of poor response after AIH treatment.Results Patients with fatigue,nausea and jaundice in the poor response group accounted for 75.00%,79.16%,83.33%,79.17%and 75.00%of those with positive ANA and AMA antibodies,which were significantly higher than those in the good response group(25.00%,20.83%,16.67%,20.83%and 25.00%,all P<0.05).The results of multivariate logistic regression analysis showed that patients with AIH had symptoms of asthenia,nausea and jaundice.The high expression of ALP was a risk factor for poor response after treatment,all of which were P<0.05.Conclusion Patients with poor response to AIH often have symptoms of asthenia,nausea and jaundice,and ALP in serum shows high expression,which are risk factors for poor response on treatment.