自身免疫性肝炎合并慢性布鲁菌病1例并文献复习  

A case of concomitant autoimmune hepatitis and Brucellainfection

作　　者：林宇岚[1] 陈守涛[1] 甘龙杰[1] 张维清[1] 江丽[1] 梁晓华[1] 高丽钦[1] 欧启水[1] 杨滨[1] LIN Yulan CHEN Shoutao GAN Longiie ZHANG Weiqing JIANG Li LIANG Xiaohua GAO Liqin OU Qishui YANG Bin(Clinical Laboratory, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350004, Chin)

机构地区：[1]福建医科大学附属第一医院检验科,福建福州350004

出　　处：《中国微生态学杂志》2016年第11期1285-1288,共4页Chinese Journal of Microecology

基　　金：福建省卫生厅青年科研基金资助(2013-2-40)

摘　　要：目的探讨自身免疫性肝炎合并布鲁菌感染时的临床特征、诊断及其治疗等特点。方法回顾性分析我院确诊的1例自身免疫性肝炎合并慢性布鲁菌感染患者的临床特点、相关指标的检测结果并结合文献报道进行总结。结果患者临床表现缺乏特异性。血培养和血清抗体检测呈阳性,C-反应蛋白(CRP)可见升高而降钙素原(PCT)变化不明显。结论布鲁菌病不能仅从临床表现来鉴别和诊断,更不能因为缺少流行病学资料而否定。自身免疫性肝炎患者的CRP水平对急性炎症的敏感性会降低,但仍可以作为疗效判断的参考指标。应适度增加疗程,定期复查,以更好的控制慢性布鲁菌感染。Objective To investigate the clinical features,diagnosis,and treatment of concomitant auto-immune hepatitis and Brucellainfection.Methods A retrospective analysis and literature review were conducted on the clinical manifestations and therapy of the case.Results The clinical manifestations of the patient were not specific,and the results of blood culture and antibody detection were positive.In addition,the level of C-reactive protein（CRP）increased while that of procalcitonin did not change obviously.Conclusion Brucellosis should not be identified and diagnosed based on clinical symptoms only,nor be excluded due to lack of epidemiological data.The level of CRP of this patient can still be used as a reference index to evaluate the effect of anti-brucella treatment,although the sensitivity of CRP of the patient with autoimmune hepatitis may decrease in the case of acute Brucellainflammation.It is necessary to increase the course of treatment and check regularly in order to control chronic Brucellainfection.

关 键 词：自身免疫性肝炎 布鲁菌病 

分 类 号：R378[医药卫生—病原生物学]