自身免疫性肝炎治疗应答速度与疾病进展的相关性

张红霞; 郭丽萍; 周璐; 王邦茂

doi:10.3969/j.issn.1001-5256.2018.04.025

自身免疫性肝炎治疗应答速度与疾病进展的相关性

DOI: 10.3969/j.issn.1001-5256.2018.04.025

天津医科大学总医院消化科

基金项目:

国家自然科学基金资助项目(81470834)；

详细信息

中图分类号: R575.1
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出版历程
- 出版日期: 2018-04-20

Association between the rapidity of response and progression to cirrhosis in patients with autoimmune hepatitis

Department of Gastroenterology, General Hospital of Tianjin Medical University

Research funding:

摘要

摘要:
目的评价自身免疫性肝炎（AIH）患者治疗应答速度与肝硬化进展的关系,分析影响应答速度的因素。方法回顾性分析2001年11月-2017年5月在天津医科大学总医院就诊的61例长期随访的AIH患者的临床资料,依据血清转氨酶应答速度（即转氨酶降至正常水平所需时间）分为<3个月组、36个月组、612个月组、1224个月组、>24个月组。比较各组的持续应答率及肝硬化进展率,并分析影响应答速度的因素。正态分布的计量资料2组比较采用两独立样本t检验,多组比较采用单因素方差分析。计数资料2组比较采用χ2检验,多组比较采用列联表卡方检验。结果转氨酶在3个月内降至正常的患者发生肝硬化的比例（20%）最低,肝功能持续2年未降至正常的2例患者全部进展为肝硬化,肝功能持续1年未降至正常的患者有一半以上（62.5%）进展为肝硬化。比较3个月内应答者与3个月内未应答者肝硬化的进展率（20%vs 48.15%）,发现早期应答较晚期应答者肝硬化进展的比例低,差异有统计学意义（χ2=5.067,P<0.05）。将3个月内应答组（20%）分别...
- 肝炎,自身免疫性 /
- 肝硬化 /
- 预后
Abstract:
Objective To evaluate the association between the rapidity of response and progression to cirrhosis in patients with autoimmune hepatitis (AIH) , and to analyze the influencing factors for the rapidity of response.Methods A retrospective analysis was performed on 61 AIH patients with long-term follow-up, who visited The General Hospital of Tianjin Medical University from November 2001 to May 2017.These patients were divided into five groups according to the time for transaminase to decrease to a normal level:< 3 months group, 3-6 months group, 6-12 months group, 12-24 months group, and > 24 months group.The chi-square test was used to compare the rate of progression to cirrhosis and sustained response rate between these groups.One-way analysis of variance and the two-independent-samples t test were used to analyze the influencing factors for the rapidity of response.The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and one-way analysis of variance was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between two groups, and the contingency table chi-square test was used for comparison between multiple groups.Results The < 3 months group had the lowest proportion of patients with progression to cirrhosis (20%) ; all of the two patients in the > 24 months group progressed to cirrhosis; and 62.5% of the patients in the 12-24 months group progressed to cirrhosis.The rate of progression to cirrhosis was significantly lower in the patients who showed response within 3 months than in those who showed no response within 3 months (20% vs 48.15%, χ2= 5.067, P < 0.05) .The rates of progression to cirrhosis for the < 3 months group, 3-6 months group, 6-12 months group, 12-24 months group, and > 24 months group were 20%, 41.7%, 20%, 62.5%, and 100%, respectively, and the < 3 months group had a significantly lower rate of progression to cirrhosis than the 12-24 months group and > 24 months group (χ2= 5.546 and 6.400, both P < 0.05) .The sustained response rate of the < 3 months group was significantly higher than that of the 12-24 months group and > 24 months group (χ2= 4.322, P < 0.05) .Conclusion For AIH patients, the rapidity of response is associated with progression to cirrhosis; a rapid response reduces the rate of progression to cirrhosis.Responding within 3 months may indicate a good outcome, while responding beyond 1 year may indicate a poor outcome.Initial alanine aminotransferase level, and therapeutic drugs may influence the rapidity of response.
- hepatitis, autoimmune /
- liver cirrhosis /
- prognosis

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