原发性干燥综合征合并自身免疫性肝病的临床特征分析  

Clinical Features of Liver Injury Patients of Primary Sji gren's Syndrome with Autoimmune Liver Diseases

作　　者：张小丹[1] 陈杰[1] 黄春洋[1] 韩莹[1] 黄云丽[1] 刘燕敏[1] 单晶[1] ZHANG Xiao-dan;CHEN Jie;HUANG Chun-yang;HAN Ying;HUANG Yun-li;LIU Yan-min;SHAN Jing(Department of Immunity and Hepatology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病免疫科,北京100069

出　　处：《解放军医药杂志》2020年第11期63-66,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：北京市属医院科研培训计划(PX2019062);佑安肝病艾滋病基金资助院内中青年人才孵育项目(YNKTTS20180109)。

摘　　要：目的分析原发性干燥综合征(pSS)合并自身免疫性肝病(ALD)的肝损伤临床特征,为pSS肝损伤的诊治提供借鉴。方法回顾性分析我院2010年1月-2018年6月收治98例以肝损伤就诊的pSS患者98例的一般资料,按照合并不同ALD类型分为合并原发性胆汁性胆管炎(PBC)组30例,合并自身免疫性肝炎(AIH)组12例,单纯pSS组56例。结果AIH组年龄显著低于PBC组和pSS组,PBC组瘙痒症状、碱性磷酸酶、抗线粒体抗体阳性率显著高于AIH组和pSS组(P<0.05)。3组丙氨酸转氨酶、天门冬氨酸氨基转氨酶、总胆红素、直接胆红素、γ谷氨酰转肽酶、总胆汁酸、血清白蛋白、干燥综合征A抗体、干燥综合征B抗体阳性率比较差异无统计学意义(P>0.05)。结论pSS肝损伤伴有ALD是pSS的特殊类型,综合分析患者临床和实验室检查有助于不同类型pSS肝损伤的诊断和选择治疗方案。Objective To analyze clinical features of liver injury patients of primary sjiogren's syndrome syndrome(PSS)with autoimmune liver disease(ALD),so as to provide reference to the diagnosis and treatment of liver damage of PSS.Methods The general data of 98 patients with PSS treated in our hospital for liver damage from January 2010 to June 2018 were analyzed.According to the types of complications,they were divided into primary biliary cholangitis(PBC)group(n=30),autoimmune hepatitis(AIH)group(n=12)and PSS group(n=56).Results The age of AIH group was significantly lower than that of PBC group and pSS group,and the pruritus symptom,ALP,positive rate of anti-mitochondrial antibody was significantly higher in PBC group than in AIH group and pSS group(P<0.05).There was no significant difference in the positive rates of alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,γglutamyltranspeptidase,total bile acid,albumin,Sjogren's syndrome A antibody and Sjogren's syndrome B antibody among the three groups(P>0.05).Conclusion The liver damage of pSS associated with autoimmune liver disease is a special type of pSS.Comprehensive analysis of clinical and laboratory examination helps the diagnosis of liver damage of pSS associated with/without autoimmune liver disease.

关 键 词：原发性干燥综合征 肝炎 自身免疫性 丙氨酸转氨酶 天冬氨酸氨基转移酶类 胆红素 抗核抗体 血清白蛋白 

分 类 号：R593.22[医药卫生—内科学]