自身免疫性肝炎和原发性胆汁性肝硬化患者自身免疫性甲状腺疾病流行率调查  

Coincidence of autoimmune thyroid diseases in patients with autoimmune hepatitis and primary biliary cirrhosis

作　　者：徐艳 于秉楠 武剑[2] Xu Yan;Yu Bingnan;Wu Jian(Clinical Laboratory,Integrated Traditional Chinese and Western Medicine Hospital,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]苏州市中西医结合医院检验科,江苏省苏州市215000 [2]苏州大学附属第一医院检验科

出　　处：《实用肝脏病杂志》2022年第1期42-45,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金青年基金项目(编号:81503474)。

摘　　要：目的调查自身免疫性肝病(AILD)患者自身免疫性甲状腺疾病(AITD)发病率情况。方法2018年6月~2020年12月我院诊治的自身免疫性肝炎(AIH)41例和原发性胆汁性肝硬化(PBC)患者45例,采用间接免疫荧光法或免疫印迹法检测血清抗核抗体(ANA)、抗线粒体抗体(AMA)或(AMA-M2)、抗平滑肌抗体(ASMA)、抗双链DNA抗体(抗dsDNA)和抗着丝点抗体(ACA);采用ELISA法检测血清免疫球蛋白,包括IgG、IgM和γ-球蛋白。结果在本组41例AIH患者中,合并HT患者12例,合并GD患者6例,在45例PBC患者中,合并HT患者8例,合并GD患者7例;AIH患者血清IgG水平为17.5(14.8,19.8)g/L,显著低于AIH合并HT组【21.6(17.5,29.0)g/L,P<0.05】或AIH合并GD组【22.4(20.2,26.4)g/L,P<0.05】,血清γ-球蛋白为22.2(19.3,25.6)%,显著低于合并HT组【26.5(22.2,32.2)%,P<0.05】或合并GD组【27.1(24.3,32.0)%,P<0.05】;PBC患者年龄为(55.2±1.1)岁,显著小于合并HT组【(62.4±1.6)岁,P<0.05】或合并GD组【(62.2±1.5)岁,P<0.05】,血清IgG水平为15.4(12.2,18.0)g/L,显著低于合并HT组【20.3(16.8,24.7)g/L,P<0.05】或合并GD组【21.3(16.8,25.6)g/L,P<0.05】,血清γ-球蛋白水平为21.2(17.8,25.6)%,显著低于合并HT组【26.7(21.7,30.4)%,P<0.05】或合并GD组【25.4(22.2,29.4)%,P<0.05】。结论AILD合并AITD的发病率较高,合并AITD患者血清IgG和γ-球蛋白水平较高,其原因还有待于进一步研究。Objective The aim of this study was to investigate the coincidence of autoimmune thyroid diseases(AITD)in patients with autoimmune hepatitis(AIH)and primary biliary cirrhosis(PBC).Methods A total of 41 patients with AIH and 45 patients with PBC were recruited in this study between June 2018 and December 2020,and serum anti-nuclear antibody(ANA),anti-mitochondrial antibody(AMA)and/or anti-mitochondrial antibody M2(AMA-M2),anti-smooth muscle antibody(ASMA),anti-double-stranded DNA antibody(anti-dsDNA)and anti-centromere antibody(ACA)were detected.Results Out of 41 patients with AIH in our series,12 patients had Hashimoto's thyroiditis(HT),and 6 had Grave’s disease(GD),and out of 45 patients with PBC,8 had HT,and 7 had GD;serum IgG level in patients with AIH was 17.5(14.8,19.8)g/L,significantly lower than[21.6(17.5,29.0)g/L,P<0.05]in patients with AIH and HT or[22.4(20.2,26.4)g/L,P<0.05]in patients with AIH and GD,serumγ-globulin level was 22.2(19.3,25.6)%,significantly lower than[26.5(22.2,32.2)%,P<0.05]in patients with AIH and HT or[27.1(24.3,32.0)%,P<0.05]in patients with AIH and GD;the age of patients with PBC was(55.2±1.1)yr old,significantly younger than[(62.4±1.6)yr old,P<0.05]in patients with PBC and HT or[(62.2±1.5)yr old,P<0.05]in patients with PBC and GD,serum IgG level was 15.4(12.2,18.0)g/L,significantly lower than[20.3(16.8,24.7)g/L,P<0.05]in patients with PBC and HT or[21.3(16.8,25.6)g/L,P<0.05]in patients with PBC and GD,serumγ-globulin level was 21.2(17.8,25.6)%,significantly lower than[26.7(21.7,30.4)%,P<0.05]in PBC patients with HT or[25.4(22.2,29.4)%,P<0.05]in patients with PBC and GD.Conclusion The coincidence of AITD in patients with AILD is common,and serum IgG andγ-globulin levels increase in patients with AIH or PBC with concomitant AITD,which needs further investigation.

关 键 词：自身免疫性肝炎 原发性胆汁性肝硬化 自身免疫性甲状腺疾病 流行 

分 类 号：R575.2[医药卫生—消化系统] R581[医药卫生—内科学]