【摘要】 目的探讨自身免疫性肝病(ALD)的临床和病理学特点.方法回顾昆明医学院第二附属医院肝胆胰内科2004年1月至2009年5月间收治的自身免疫性肝病(ALD)患者92例(AIH 16例,PBC 55例,AIH/PBC重叠综合征21例)的临床资料.结果 92例ALD患者男:女之比为1:4,平均年龄49.52岁;16例AIH以丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)和IgG升高为主;55例PBC以碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)和IgM升高为主;21例AIH/PBC重叠综合征兼有以上特点.AIH患者抗核抗体(ANA)多为阳性,PBC患者抗线粒体抗体(AMA-M2)多为阳性,AIH/PBC重叠综合征同时检测到ANA、AMA为阳性.结论 ALD多发于中老年女性,肝功、血清免疫学及自身抗体的检测对诊断具有重要的作用,肝脏组织病理学检查有助于ALD的诊断与鉴别诊断.更多还原

【Abstract】 Objective To analyze the clinical and pathological characteristics of autoimmune hepatitis.Method The clinical data of 92 patients with autoimmune hepatitis(16 patients with AIH,55 patients with PBC,21 patients with PBC-AIH overlap syndrome)were retrospectively analyzed in our department from January 2004 to May 2009.Results The male to female ratio of 92 patients was 1:4,and the average age was 49.52 years.Laboratory investigations revealed elevated serum ALT,AST,and IgG and positive antinuclear antibodies in 16 cases of AIH.The most elevated biochemical indexes were ALP,GGT,IgM and AMA M2 auto-antibodies positive in 55 cases of PBC.The patients with PBC-AIH overlap patients had both features of patients with AIH and patients with PBC.Conclusion Autoimmune liver disease occurs in middle-aged women,liver function,serum immunology and diagnosis of auto-antibodies plays an important role in pathological changes in liver tissue can help with diagnosis and differential diagnosis of autoimmune liver disease.更多还原