| 原发性胆汁性肝硬化和自身免疫性肝炎的临床特点分析 |
| 投稿时间：2016-06-15 修订日期：2016-06-27 点此下载全文 |
| 引用本文：黄敏,陈继红.原发性胆汁性肝硬化和自身免疫性肝炎的临床特点分析[J].医学研究杂志,2017,46(2):86-89,107 |
| DOI：
10.11969/j.issn.1673-548X.2017.02.024 |
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| 中文摘要:目的 提高对原发性胆汁性肝硬化（PBC）和自身免疫性肝炎（AIH）的认识，协助临床诊疗。方法 回顾性分析49例PBC患者和61例AIH患者的临床、生化、免疫和肝脏组织学方面的特点。结果 PBC组和AIH组均为女性高发，两者均以乏力、食欲不振、黄疸、腹胀等症状常见，皮肤瘙痒为PBC组相对特异性症状；PBC组初诊为肝硬化者占48.8%（24/49），高于AIH组31.1%（19/61）；PBC组门冬氨酸氨基转移酶（GGT）、碱性磷酸酶（ALP）、IgM、IgM/IgG水平、血脂异常及抗线粒体抗体（AMA）阳性率明显高于AIH组（P<0.05）；AIH组丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、IgG水平及抗平滑肌抗体（ASMA）和抗肝肾微粒抗体（LKM）阳性率明显高于PBC组（P<0.05）。结论 PBC和AIH这两种疾病在临床、肝酶、免疫球蛋白、血脂代谢异常及自身抗体方面具有不同特征。 |
| 中文关键词:原发性胆汁性肝硬化 自身免疫性肝炎 临床表现 生化检查 自身免疫抗体 |
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| Clinical Characteristics of Primary Biliary Cirrhosis and Autoimmune Hepatitis |
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| Abstract:Objective To improve the understanding of primary biliary cirrhosis(PBC) and autoimmune hepatitis(AIH) and then offer help in the clinical diagnosis and treatment. Methods A respective study was made in 49 patients with PBC and 61 patients with AIH. The clinical, biochemical, immunological and histological features of PBC and AIH were compared. Results Female predominance were seen and symptoms such as fatigue, anorexia, jaundice, abdominal distension were common among the patients of PBC and AIH, skin itching was relatively specific symptom for PBC. Patients with PBC in the first diagnosis of cirrhosis accounted for 48.8%(24/61), higher than those in AIH 31.1%(19/61). Patients with PBC exhibited higher levels of serum gammaglutamy1 transferase(GGT),alkaline phosphatase(ALP), IgM, IgM/IgG,dyslipidemia and the positive rate of anti-mitochondrial antibody(AMA) were significantly higher than those in AIH(P<0.05). Serum alanine aminotransterase(ALT),aspartate aminotransterase(AST),the concentration of IgG and the positive rate of anti-smooth muscle antibody(ASMA) and anti-liver kidney microsomal antibody(LKM) were higher in AIH patients(P<0.05). Conclusion There were different characteristics in aspects of clinical, liver enzymes, immune globulin, blood lipid metabolism abnormalities and autoimmune antibodies among PBC and AIH patients. |
| keywords:Primary biliary cirrhosis Autoimmune hepatitis Clinical feature Biochemical examination Autoimmune antibody |
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