120例I型自身免疫性肝炎临床特征与疗效相关因素分析  

Analyses of clinical features and associated factors on curative effect in type 1 autoimmune hepatitis with 120 cases

作　　者：汪嘉莉[1] 姚云清[1] 

机构地区：[1]重庆医科大学附属第一医院感染科,400016

出　　处：《临床内科杂志》2012年第3期187-189,共3页Journal of Clinical Internal Medicine

摘　　要：目的分析120例I型自身免疫性肝炎（AIH-1）患者的临床表现特征以及疗效相关因素，以期进一步优化AIH-1患者的临床诊疗工作。方法回顾性分析120例AIH-1患者的临床症状、体征、生化检查、免疫球蛋白、自身抗体、肝脏组织学检查、治疗方案及疗效。结果AIH-1患者以乏力、黄疸、脾大为主要临床表现，白蛋白（ALB）水平轻度下降，总胆红素（TBIL）、直接胆红素（DBIL）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转氨酶（AST）、碱性磷酸酶（ALP）和1一谷酰转移酶（GGT）升高；治疗失败组与缓解组比较，ALB、ALT和AST降低（P〈0．05），TBIL和DBIL升高（P〈0．01）。AIH．1多因素分析显示，ALB、TBIL、AST、免疫球蛋白G（IgG）及症状与疾病预后相关。结论AIH．1患者的临床特征对早期诊断有重要意义；ALB、TBIL、AST、IgG、症状可能与AIH-1预后相关，早期判断及早期特异治疗有可能预后。Objective To provide advantage diagnoses and standard therapies for AIH-l,we analyzed clinical features and influencing factors on curative effect in type 1 autoimmune hepatitis （AIH-1） with 120 cases. Method Retrospectively analyzed the clinical symptoms, physical signs, examinations of biochemistry,immunoglobulin, autoantibody, histopathology, treatment protocals and the curative effect in AIH-1 patients. Results For AIH-1 cases,the most common symptoms were fatigue,jaundice and splenomegaly. Serum albumin （ ALB ） levels were reduced. However total bilirubin （ TBIL ）, direct bilirubin （ DBIL）, alanine aminotransferase （ ALT）, aspartate aminotransferase （ AST）, serum alkaline phosphatase （ALP） and gamma-glutamyl transpeptidase（GGT） levels were raised. ALB, ALT and AST levels were sig- nificantly lower in therapy failure group compared with remission group （P 〈 0.05 ）, TBIL and DBIL levels were significantly higher than those in remission group（ P 〈 0.01 ）. Multivariate analysis with the above factors showed ALB,TBIL, AST,immunaglobulin G（IgG） and clinical symptoms were associated with the prognosis of AIH-I. Conchmiou The clinical features is significantly important in the early diagnosis for AIH-1. ALB, TBIL, AST, IgG and clinical symptoms might be associated with the prognosis of AIH-1. Early diagnosis and specific treatment might be of benifit for better prognosis.

关 键 词：I型自身免疫性肝炎 临床特征 相关因素 疗效 

分 类 号：R593.2[医药卫生—内科学]