慢性自身免疫性肝病78例临床分析

Clinic Study on 78 Cases of Autoimmune Chronic Liver Disease

目的:探讨自身免疫性肝病的临床、生化特点和病原抗体表达情况及一般治疗规律。方法:观察78例慢性自身免疫性肝病(ACLD)的临床表现并分析肝功能、血生化、自身抗体、相关病毒抗体和B超等理化资料,8例做病理检查。结果:78例患者临床表现为伴随病多、症状多、血清碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)显著增高,与血清胆红素水平无密切相关,胆石症发生率达19.2％。轻中型病例占绝大多数,无需使用激素。禁忌免疫增强剂。两例猝死于心脑血管病。结论:ACLD临床诊断需要规范,我国ACLD可能与嗜肝病毒感染同步高发,提高诊断意识,早期进行中西医结合治疗效果较好。

Objective: To discuss the characteristics of clinical situation and biochemistry of autoimmune liver disease, the expression situation of their viral marks, and the general treatment principle of them. Methods: The clinical situation of 78 A-CLD patients were observed, at same time their liver function, biochemistry, autoantibody, relevant viral marks and B ultrasound were analysed. 8 ACLD patients had pathologic data. Results: All of patients had many associated diseases and symptoms , their levels of ALP and GGT were marked increasing. The incidence of cholelithiasis was 19.2%. Most of them were not very serious, it was not necessary to use hormones. It was not proper to use immune enhancement agents. Two of the patients sudden died because of cardia-cerebral vessels diseases. Conclusion: The clinic diagnosis of ACLD need normative standard. We should realize it is possible that one patient has ACLD and viral hepatitis at same time in the country. It is effective to treat ACLD with Chinese medicine combined western medicine in early stage.