自身免疫性抗体对药物性肝损伤的临床诊断价值  

Clinical value of autoimmune antibody detection for diagnosis of drug-induced liver injury

作　　者：陆人杰[1] 唐风雷[1] 郑中伟[2] 朱珊梅[1] 

机构地区：[1]常州市第三人民医院药事科,213001 [2]常州市第三人民医院消化内科,213001

出　　处：《肝脏》2016年第7期536-538,共3页Chinese Hepatology

摘　　要：目的探讨自身免疫性抗体(autoimmune antibody,AA)对诊断药物性肝损伤(drug-induced liver injury,DILI)的临床意义,分析不同DILI患者的AA阳性检出率的差异性。方法收集诊断为DILI患者的年龄、性别、发病时间、AA、肝功能指标及肝损药物种类等临床资料,评价DILI患者的这些临床资料与AA阳性检出率的关系。结果 DILI患者AA阳性检出率在性别、年龄分布、Child分级、临床分型以及肝损药物种类等方面与阴性检出率对比,结果差异无统计学意义。但是,随着Child评分的提高,DILI AA阳性检出率有逐步递增趋势。用药时间≥30 d的患者AA阳性检出率显著高于用药时间<30 d。结论 DILI患者AA阳性检出率与用药时间相关,对于判断是中药还是西药引起的DILI可能无明显参考价值。对于用药时间较长而出现肝功能异常的患者检测AA有一定参考意义。Objective To investigate the clinical significance of autoimmune antibody(AA)detection in the differential diagnosis of drug-induced liver injury(DILI),and its positive rate among different patients of DILI.MethodsClinical data of patients with primary diagnosis of DILI,including age,gender,disease onset time,AA,liver function index,varieties of hepatotoxic drugs,was collected for correlation analysis with AA positive rate.Results There were no differences in AA positive rate among different clinical types in respect of gender,age,liver injury type and Child score,and so on.However,AA positive rate showed positive correlation with Child score.Patients with medication time ≥ 30 days had significantly higher positive rate of AA than those with medication time < 30 days.Conclusion For DILI patients,the positive rate of AA had a positive correlation with the medication time,which suggested that AA detection might have significant referential value for abnormal liver function patients with prolong medication,but not differential diagnosis of western or Chinese drugs-induced liver injury.

关 键 词：药物性肝炎 自身免疫性抗体 阳性检出率 临床分析 

分 类 号：R575[医药卫生—消化系统]