自身免疫性肝炎63例临床特点和治疗措施分析  

作　　者：邱明好[1] 尹胜平[1] 曾菲[1] 

机构地区：[1]广西医科大学第四附属医院传染科,545005

出　　处：《浙江临床医学》2013年第4期471-473,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨自身免疫性肝炎（AIH）的临床特点和治疗措施.方法回顾性分析63例AIH患者的临床资料.结果 AIH患者63例平均43.7岁,男、女之比1∶5.3;临床表现无特异性,以乏力、纳差、尿色加深、黄疽为主, AST、ALT明显升高,球蛋白（γ-球蛋白或IgG）升高.急性与慢性AIH患者临床表现和肝功能不一样.治疗后,完全应答51例（73.01%）,部分缓解7例（12.27%）,复发3例（4.76%）,死亡2例（3.17%）.结论 AIH好发于女性,以I型最常见.AIH发病和临床表现无特异性,生化检查以肝细胞损害为主,AIH可通过自身抗体的检测结合临床持点获得诊断,激素和免疫抑制剂治疗效果较好.Objective To investigate the clinical characteristics and treatment of autoimmune hepatitis（AIH） patients. Methods The clinical data of AIH patients that were admitted to our hospital between 2005 and 2010 were collected and analyzed. Results A total of 63 patients with AIH were admitted to the hospital within 6 years. The average age of the patients was 43.7 years old. The male and female ratio was 1：5.3.The clinical manifestation were not obvious mainly including fatigue、intake difficulty,deepen the urine corlor. The gammaglobulinemia increased frequently besides the high serum level of aminotransferase、alkaline phosphatase,the seroglobulin and immunoglobulin G also rose in diverse levels. There are many different in the clinical manifestations and liver function tests of acute or chronic AIH. After treatment,the performance of glucocorticoid and immunosuppressive therapy,51 cases（73.01%）complete responsed,7 cases（12.27%）partial response,3 cases（4.76%）relapsed,2 cases（3.17%）of treatment failure and death. Conclusion AIH patients are mainly female,and the onset and clinical features are not typical.Type 1 AIH is the most common one. Hepatocyte denaturation, necrosis,plasmocyte infiltration and fibrous proliferation are dominant histological features. AIH could be diagnosed by combination of autoantibody detection and clinical manifestation. Hormones and immunosuppressive therapy is effective on autoimmune hepatitis.

关 键 词：自身免疫性肝炎 临床特点 免疫抑制剂治疗 

分 类 号：R575.1[医药卫生—消化系统]