236例自身免疫性肝病的临床分析  

Clinical analysis of 236 cases of autoimmune liver disease

作　　者：梁珍珍[1] 曾维群[1] 

机构地区：[1]重庆医科大学附属第二医院感染科,400010

出　　处：《重庆医学》2011年第36期3650-3651,3654,共3页Chongqing medicine

基　　金：重庆市卫生局基金资助项目(2009-2-202)

摘　　要：目的探讨自身免疫性肝病早期诊断及相应规范治疗方案。方法对170例自身免疫性肝炎(AIH,AIH组)、39例原发性胆汁性肝硬化(PBC,PBC组)及27例AIH-PBC重叠综合征患者(AIH-PBC组)的临床症状、实验室指标及相应治疗进行回顾性分析。结果 3组患者均有不同程度的消化道症状及乏力等非特异性临床症状和体征,免疫指标各有不同程度的异常,其中AIH以抗核抗体(ANA)阳性为主,PBC以抗线粒体抗体M2亚型(AMA-M2)阳性为主,而AIH-PBC重叠综合征兼有二者特征,三者均可合并其他自身免疫性疾病。AIH患者诊断后早期给予糖皮质激素治疗,预后较好。结论早期诊断和及时、恰当治疗对自身免疫性肝病患者的预后有重要意义。Objective To explore the early diagnosis and corresponding standard therapeutic schedule of autoimmune liver disease.Methods Retrospective analysis was conducted to investigate clinical symptoms,laboratory indicators and corresponding treatment of 170 cases of autoimmune hepatitis（AIH）（AIH group）,39 cases of primary biliary cirrhosis（PBC）（PBC group）and 27 cases of AIH-PBC overlap syndrome（AIH-PBC group）.Results All patients in 3 groups developed varying degrees of non-specific clinical symptoms and signs including gastrointestinal symptoms and fatigue.Their immune indicators showed different degrees of abnormality with positive anti-nuclear antibody（ANA）,anti-mitonchondrial antibody M2 subtype（AMA-M2） mainly founded in AIH and PBC group,respectively.Features of both ANA and AMA-M2 existed in AIH-PBC group.All the three could be associated with other autoimmune diseases.Prognosis of patients with AIH was good when glucocorticoid therapy was administrated early after diagnosis.Conclusion Early diagnosis and prompt,appropriate treatment is of great significance for the prognosis of patients with autoimmune liver disease.

关 键 词：肝炎 自身免疫性 肝硬化 胆汁性 早期诊断 糖皮质激素类 

分 类 号：R575[医药卫生—消化系统]