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194例自身免疫性肝炎患者的临床特征分析
Clinical characteristics of autoimmune hepatitis: an analysis of 194 patients
文章发布日期:2015年08月11日  来源:  作者:邓拥军,肖明中,李晓东,等  点击次数:1394次  下载次数:289次

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【摘要】:目的探讨自身免疫性肝炎(AIH)患者的主要临床特征。方法收集2010年12月-2014年12月于湖北省中医院光谷院区就诊的194例AIH患者资料,另外收集197例健康献血者作为对照组。检测AIH患者的自身抗体、生化指标及肝脏病理学表现,根据自身抗体的检测情况对AIH患者分型,并对全部AIH患者的年龄、性别、生化指标和病理表现进行统计分析。计量资料组间比较采用方差分析,计数资料组间比较采用χ2检验。结果194例AIH患者中女/男为154/40,40~60岁为AIH的发病高峰,年龄>40岁的患者占76.80%(149/194)。依据自身抗体检测情况,194例AIH患者中Ⅰ、Ⅱ、Ⅲ型的人数分别为163、5、26例,女/男分别为:131/32、4/1、19/7,年龄分别为(59.26±10.24)、(16.54±8.21)、(63.38±12.92)岁。AIH中Ⅰ型与Ⅱ、Ⅲ型的ALT 、AST、GGT、IgG检测值差异均有统计学意义(P值均<0.05),AIH中Ⅱ型与Ⅰ、Ⅲ型的IgA检测值差异有统计学意义(P值均<0.05)。AIH病理表现主要为界面性肝炎、淋巴细胞及浆细胞浸润和玫瑰花结样改变。结论AIH以女性且年龄>40岁患者为主,40~60岁为发病高峰,Ⅰ、Ⅱ、Ⅲ型AIH的生化指标有不同程度的升高,病理表现主要为界面性肝炎。
【Abstract】:Objective To investigate the main clinical characteristics of patients with autoimmune hepatitis (AIH). Methods An analysis was performed on the data of 194 AIH patients who visited Guanggu Branch of Hubei Provincial Hospital of Traditional Chinese Medicine from December 2010 to December 2014 and 197 healthy blood donors who served as control group. Autoantibodies, biochemical indicators, and liver biopsy were evaluated for AIH patients. The type of AIH patients was determined according to the results of test of autoantibodies and a statistical analysis was conducted for age, sex, biochemical markers, and pathological manifestations of all the AIH patients, Comparison of continuous data between groups was made by analysis of variance and comparison of categorical data between groups was made by chi-square test. Results The female/male ratio was 154∶40 among the 194 AIH patients. The morbidity achieved a peak value among the patients aged 40-60 years. The proportion of the patients older than 40 years were 76.80% (149/194). According to the results of test of autoantibodies, the numbers of type-Ⅰ, -Ⅱ, and -Ⅲ AIH patients were 163, 5, and 26, respectively, the female/male ratios were 131∶32, 4∶1, and 19∶7, respectively, and the mean ages were 59.26±10.24, 16.54±8.21, and 63.38±12.92 years, respectively. There were significant differences in alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, and immunoglobulin G between type-Ⅰ AIH patients and type-Ⅱ and -Ⅲ AIH patients (all P<0.05), and immunoglobulin A significantly differed between type-Ⅱ AIH patients and type-Ⅰ and -Ⅲ AIH patients (P<0.05). Pathological manifestations of AIH showed interface hepatitis, infiltration of lymphocytes and plasma cells, and rosette-like changes. Conclusion AIH patients are mostly female aged 40-60 years. The peak age of onset ranges from 40 to 60 years. Biochemical indicators have various degrees of increase among type-Ⅰ, -Ⅱ, and -Ⅲ AIH patients. The main pathological manifestation is interface hepatitis.
【关键字】:肝炎,自身免疫性;自身抗体;临床化学试验;病理学,临床
【Key words】:hepatitis, autoimmune; autoantibody; clinical chemistry tests; pathology, clinical
【引证本文】:邓拥军, 肖明中, 李晓东, 等. 194例自身免疫性肝炎患者的临床特征分析[J]. 临床肝胆病杂志, 2015, 31(9): 1473-1476.

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