102例住院的自身免疫性肝病患者临床特征分析  

Clinical features of 102 hospitalized patients with autoimmune liver diseases

作　　者：刘少锋[1] 马雄[2] 

机构地区：[1]皖南医学院附属弋矶山医院消化内科,安徽省芜湖市241001 [2]上海交通大学医学院附属仁济医院消化内科/上海市消化病研究所

出　　处：《实用肝脏病杂志》2014年第5期511-514,共4页Journal of Practical Hepatology

摘　　要：目的分析住院的自身免疫性肝病(AILD)患者的临床特征。方法详细记录和分析102例住院的AILD患者的临床资料,包括一般资料、实验室检查、肝脏穿刺检查和治疗方案。结果 102例(新增54例,复诊48例)AILD患者的平均年龄为(50.32±12.87)岁,性别比为女/男=5.8/1;51例自身免疫性肝炎(AIH)患者和25例原发性胆汁性肝硬化(PBC)患者的平均年龄分别为(48.38±13.88)岁和(54.95±14.33)岁,男女比例分别为1/9.4和1/4,两组年龄和性别差别无统计学意义;在新增的54例患者中,22例行肝穿刺的AIH患者血清丙氨酸氨基转移酶(ALT)为(565.3±482.9)U/L,显著高于5例行肝穿刺的PBC患者[(75.5±25.0)U/L,P<0.05)];血清免疫球蛋白IgM为(1.63±0.8)g/L,显著低于PBC患者[(4.49±1.2)g/L,P<0.05];AILD患者早期诊断困难,肝脏穿刺是新增确诊患者的常见住院原因;复诊患者的住院原因多种多样,其中因失代偿期肝硬化并发症占首位,同时治疗方案要求个体化。结论 AILD住院患者病情复杂、危重,难诊难治,肝脏病理学检查具有重要的诊断价值。Objective To study the clinical characteristics of hospitalized patients with autoimmune liver diseases（AILD）. Methods The clinical data including age and gender,laboratory tests,liver biopsy results and treatment plans in 102 hospitalized patients with AILD were collected and analyzed. Results The mean age of102 patients was（50.32±12.87） years old and the female/male ratio was 5.8/1. The mean age of 51 hospitalized patients with autoimmune hepatitis（AIH） was（48.38 ±13.88）years old and the female/male ratio was 9.4/1;the mean age of 25 hospitalized patients with primary biliary cirrhosis（PBC） was（54.95±14.33） years old and the female/male ratio was 4/1. The differences in average age and gender ratio between the AIH and PBC patients were not statistically significant;Among the newly diagnosed patients who had underwent liver biopsies,the mean level of serum alanine aminotransferase（ALT） in 22 patients with AIH was（565.3 ± 482.9） U/L,significantly higher than in 5 patients with PBC [（75.5±25.0） U/L,P〈0.05）];the mean level of serum IgM in patients with AIH was（1.63 ±0.8） g/L,significantly lower than in patients with PBC [（4.49 ±1.2） g/L,P 0.05];The early diagnosis of AILD patients was difficult,and liver biopsy was the common cause of hospitalization in the newly diagnosed patients. There were a variety of reasons for hospitalization,among which cirrhosis complications accounted for the majority. The treatment programs were more individualized. Conclusions The conditions of the hospitalized patients with AILD are often complex,criticall and difficult in diagnosis and therapy. Liver biopsies is important and valuable for the diagnosis of AILD.

关 键 词：自身免疫性肝病 临床特征 肝活检 治疗 

分 类 号：R575[医药卫生—消化系统]