药物性肝损伤患者自身抗体的检出率及其临床意义  

Detection rates of autoantibodies in patients with drug-induced liver injury and their clinical significance

作　　者：姜红丽 祁亚宾 张睿[3] 胡玉琳[3] JIANG Hongli;QI Yabin;ZHANG Rui(Sixth Therapeutic Area,Department of Internal Medicine,Hepatology Hospital of Jilin Province,Changchun 130062,China)

机构地区：[1]吉林省肝胆病医院内科六疗区,长春130062 [2]河南省人民医院,郑州450000 [3]吉林大学第一医院,长春130021

出　　处：《临床肝胆病杂志》2018年第1期164-167,共4页Journal of Clinical Hepatology

摘　　要：目的探讨药物性肝损伤患者自身抗体的检出率及其临床意义。方法选取2009年1月-2013年12月吉林大学第一医院收治的药物性肝损伤患者132例,同时收集同期住院治疗的慢性乙型肝炎患者96例为对照。统计并分析患者自身抗体的检出率、自身抗体的种类及滴度,以及患者年龄、性别、肝损伤药物种类、发病时间、肝功能生化、凝血常规指标等。计数资料组间比较采用χ~2检验。结果药物性肝损伤患者自身抗体的检出率为60.6%(80/132),主要为抗核抗体、抗平滑肌抗体、抗线粒体抗体,检出率分别为56.1%、12.9%、3.0%,抗体滴度以低滴度、中滴度为主。慢性乙型肝炎组自身抗体的检出率为45.8%(44/96),低于药物性肝损伤组,差异有统计学意义(χ~2=4.889,P=0.027)。药物性肝损伤患者自身抗体的检出率与性别、年龄、分型、Child-Pugh分级均无关;与用药时间相关,用药时间>1个月与≤1个月患者自身抗体阳性率比较差异有统计学意义(68.9%vs 40.6%,χ~2=7.963,P=0.004 8)。结论药物性肝损伤患者可检测出多种自身抗体,主要以低、中滴度自身抗体为主,抗核抗体最为常见。用药时间越长,自身抗体的检出率越高。Objective To investigate the detection rates of autoantibodies in patients with drug-induced liver injury(DILI)and their clinical significance.Methods A total of 132 patients with DILI who were admitted to The First Hospital of Jilin University from January 2009 to December 2013 were enrolled,and 96 patients with chronic hepatitis B(CHB)who were hospitalized during the same period of time were enrolled as controls.The patients were analyzed with respect to the detection rate of autoantibody,titers and types of autoantibodies,age,sex,type of drugs inducing liver injury,time of onset,biochemical parameters for liver function,and coagulation parameters.The chi-square test was used for comparison of categorical data between groups.Results In the patients with DILI,the detection rate of autoantibodies was 60.6%(80/132),and the detection rates of anti-nuclear antibody,anti-smooth muscle antibody,and anti-mitochondrial antibody were 56.1%,12.9%,and 3.0%,retrospectively;the antibody titer was mainly low titer and moderate titer.In patients with CHB,the detection rate of autoantibodies was 45.8%(44/96),which was significantly lower than the detection rate in the patients with DILI(χ^2=4.889,P=0.027).In the patients with DILI,the detection rate of autoantibodies was not associated with sex,age,typing,or Child-Pugh class,while it was associated with medication time,and there was a significant difference in the positive rate of autoantibody between the patients with a medication time of >1 month and those with a medication time of≤1 month(68.9%vs 40.6%,χ^2=7.963,P=0.004 8).Conclusion A variety of autoantibodies can be detected in patients with DILI,mainly low-and moderate-titer autoantibodies,among which anti-nuclear antibody is the most common one.The detection rate of autoantibody increases with the increase in medication time.

关 键 词：药物性肝损伤 自身抗体 

分 类 号：R575[医药卫生—消化系统]