自身免疫性肝炎与药物性肝损伤患者血清抗体和肝组织病理学特点分析  

Study on the characteristics of serum antibody and liver histopathology in patients with autoimmune hepatitis and drug-induced liver injury

作　　者：凌伟 李勇[1] 许爱萍[1] 曹季军[1] 王金湖[1] LING Wei;LI Yong;XU Aiping;CAOJijun;WANG Jinhu(Department of Clinical Laboratory,Taicang First People’s Hospital,Taicang,Jiangsu 215400,China)

机构地区：[1]太仓市第一人民医院检验科,江苏太仓215400

出　　处：《医药前沿》2021年第32期14-15,18,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析自身免疫性肝炎与药物性肝损伤患者血清抗体和肝组织病理学特点。方法:选取2018年11月—2019年11月我院接受治疗的40例自身免疫性肝炎患者和50例药物性肝损伤的患者,对两组患者的血清抗体、肝组织病理学情况等特点进行比较分析。结果:肝功能指标的对比中,药物性肝损伤患者的丙氨酸转氨酶(ALT)、草氨酸转氨酶(AST)、白蛋白(ALB)和总胆红素(TBIL)的指标均高于自身免疫性肝炎的患者,差异均有统计学意义(P<0.05),两组患者CHE1、ALP和GGT比较,差异均无统计学意义(P>0.05);药物性损伤患者的血清抗体阳性率除ANA外,其他指标均低于自身免疫性肝炎患者,差异有统计学意义(P<0.05);药物性损伤患者在汇管区中性粒细胞浸润和肝内胆汁淤积的发生情况呈现出更高的趋势,浸润淋巴细胞、浸润浆细胞和肝细胞玫瑰花样结构的发生情况则自身免疫性肝炎的发生率更高,差异有统计学意义(P<0.05)。结论:自身免疫性肝炎与药物性肝损伤患者在血清抗体、肝组织病理学和免疫学上有着显著差异,通过此种检测,可对患者的病情进一步鉴别和诊断起到重要作用,为患者提供更准确的治疗。Objective To investigate the characteristics of serum antibody and liver histopathology in patients with autoimmune hepatitis and drug-induced liver injury.Methods 40 patients with autoimmune hepatitis and 50 patients with drug-induced liver injury treated in our hospital from November 2018 to November 2019 were selected as research objects.The characteristics of serum antibody and liver histopathology were compared and analyzed between the two groups.Results The indexes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB)and total bilirubin(TBIL)in patients with drug-induced liver injury were higher than those in patients with autoimmune hepatitis,and the difference was statistically significant(P<0.05).There was no significant difference in TBIL,ALP and GGT between the two groups(P>0.05).The positive rate of serum antibody in patients with drug-induced injury is higher than that in patients with autoimmune hepatitis,and in the comparison of serum indexes,the patients with drug-induced injury also show a higher trend,and the difference is statistically significant(P<0.05).Conclusion The incidence of neutrophil infiltration and intrahepatic cholestasis in patients with drug-induced injury showed a higher trend,and the hair of infiltrating lymphocytes,infiltrating plasma cells and hepatocyte rose pattern structure.

关 键 词：自身免疫性肝炎 药物性肝损伤 血清抗体 病理学特点 

分 类 号：R575.1[医药卫生—消化系统]