汉族人群性别差异对Ⅰ型自身免疫性肝炎临床特征的影响  

Impact of gender difference on clinical features of type 1 autoimmune hepatitis in Chinese Han

作　　者：游忠岚[1] 陈文[1] 卢苇[1] 但芸婕[1] 邓国宏[1] 毛青[1] 陈嵩[1] 

机构地区：[1]第三军医大学西南医院全军感染病研究所,重庆400038

出　　处：《第三军医大学学报》2010年第12期1351-1353,共3页Journal of Third Military Medical University

摘　　要：目的分析中国汉族人群性别差异对Ⅰ型自身免疫性肝炎(type1 autoimmune hepatitis,AIH-1)临床特征的影响。方法收集2002年1月至2009年12月确诊的113例(男26例,女87例)中国汉族Ⅰ型自身免疫性肝炎患者肝组织、血清标本,以及人口统计学资料。采用间接免疫荧光法检测血清抗核抗体(antinuclear antibodies,ANA)、抗平滑肌抗体(smooth muscle antibodies,SMA)、Ⅰ型抗肝肾微粒体抗体(liver/kidney microsome type1,抗LMK-1)及其他自身抗体,并分析患者肝组织病理学及人口统计学特征。结果男性AIH-1患者肝硬化发生平均年龄为60.62岁,女性患者肝硬化发生平均年龄为47.17岁,两者之间差异有显著统计学意义(t=2.876,P=0.007)。男性与女性AIH患者血清ALT、AST和总胆红素水平,以及在临床表现、ANA和/或SMA阳性率及肝组织病理学方面差异无统计学意义(P>0.05)。女性AIH-1患者的血清IgG水平明显高于男性患者[(21.86±9.12)g/Lvs(17.49±8.58)g/L,t=2.017,P=0.046]。结论汉族女性AIH-1患者肝硬化发生年龄明显低于男性患者,可能与女性患者肝脏反复炎症活动有关。Objective To investigate the influence of gender on clinical characteristics in Chinese Han patients with type 1 autoimmune hepatitis. Methods As much as 113 Chinese patients diagnosed with definite AIH,who underwent liver biopsy between 2002 and 2009,and had frozen serum samples and clinical data available from the time of biopsy,were selected for this study. The presence of anti-nuclear antibodies （ANA）,smooth muscle antibodies （SMA） and liver-kidney microsome type 1 （anti-LKM1） were measured by indirect immunofluorescence assay. All of the liver biopsies were reviewed in a blinded manner by the same expert pathologist. The charts were extensively reviewed for demographic and liver features obtained at the time of the biopsy. Of the 113 patients,26 were male AIH patients. Results Median age at cirrhosis onset was 60.62 years old in men and 47.17 years old in women （t=2.876,P=0.007）. Positivity for ANA,ASMA and anti-LKM1 did not differ between the 2 groups. There was no significant difference in clinical manifestations at presentation. Our analysis indicated that no histopathological class of AIH was predominant in both males and females. Interestingly,the serum immunoglobulin G levels were higher in the female AIH patients compared to the male AIH group （21.86±9.12 vs 17.49±8.58 g/L,t=2.017,P=0.046）. In addition,whilst the mean levels of serum aspartate aminotrans ferase,bilirubin and albumin were markedly altered（P0.05）,they were comparable between both AIH men and women. Conclusion Women with AIH-1 appear to have a younger age of cirrhosis onset,which may relate to repeated prevalence of liver inflammation.

关 键 词：肝炎 自身免疫性 性别 肝硬化 

分 类 号：R575.1[医药卫生—消化系统] R195.4[医药卫生—内科学]