自身免疫性肝炎与系统性红斑狼疮肝损的异质性  

Heterogeneity between Autoimmune Hepatitis and Liver Damage in Systemic Lupus Erythematosus

作　　者：於强[1] 王吉耀[1] 姜林娣[1] 张锦生[2] 

机构地区：[1]复旦大学附属中山医院内科,上海200032 [2]复旦大学基础医学院病理学教研室,上海200032

出　　处：《中国临床医学》2001年第4期366-368,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :研究自身免疫性肝炎 (AutoimmuneHepatitis ,AIH)的临床表现 ,肝活检病理以及与系统性红斑狼疮 (SLE)肝损害的异同。方法 :回顾性总结 15例AIH及 2 0例SLE肝损害患者的临床及肝活检病理。结果 :AIH表现为丙氨酸转氨酶(ALT)、天冬氨酸转氨酶 (AST)异常 ,高球蛋白、高γ球蛋白血症 ,存在多种自身抗体 ,伴发自身免疫性疾病 ,病理以慢性肝炎为特点 ;SLE肝损常表现在初发患者一过性ALT、AST、球蛋白、球蛋白升高 ,病理为非特异性肝损。球蛋白、γ球蛋白、免疫球蛋白G(IgG)在AIH中极显著高于SLE的肝损 (P <0 .0 0 1) ,抗双链DNA抗体 (ds-DNA)在SLE肝损病人极显著高于AIH(P <0 .0 0 1)。结论 :AIH肝病损严重 ,肝外病变多样 ,有多系统损害倾向 。Objective: To determine clinical manifestation and pathological changes by liver biopsy of autoimmune hepatitis(AIH). To detect its difference with the liver impairment of systemic lupus erythematosus(SLE). Method: The clinical manifestation and pathological changes by liver biopsy of 15 AIH patients were retrospectively compared with that of 20 SLE patients. Results: For AIH, clinically, there were extended elevation of ALT and AST, hyperglobulinemia, hypergammaglobulinemia and different kinds of antibodies. Patients usually had autoimmune diseases with pathologically change of typical chronic hepatitis. Liver damages in initial SLE included temporary elevation of ALT, AST, globulinemia, gammaglobulinemia. Its pathologic change was nonspecific damage. The levels of globulin, gammaglobulin in AIH were significantly higher than that of SLE liver impairment( P < 0.001) . Anti-dsDNA antibody of SLE liver impairment were significantly higher than that of AIH( P < 0.001). Conclusion: AIH has severe liver impairment with many other symptoms due to multi-systemic damage out of liver. AIH is a distinct disease and is completely different from liver damage of SLE.

关 键 词：自身免疫性慢性肝炎 系统性红斑狼疮 异质性 AIH 

分 类 号：R512.6[医药卫生—内科学] R593.241[医药卫生—临床医学]