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自身免疫性肝炎与系统性红斑狼疮肝损的异质性 预览 被引量:4

Heterogeneity between Autoimmune Hepatitis and Liver Damage in Systemic Lupus Erythematosus
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摘要 目的:研究自身免疫性肝炎(Autoimmune Hepatitis,AIH)的临床表现,肝活检病理以及与系统性红斑狼疮(SLE)肝损害的异同.方法:回顾性总结15例AIH及20例SLE肝损害患者的临床及肝活检病理.结果:AIH表现为丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)异常,高球蛋白、高γ球蛋白血症,存在多种自身抗体,伴发自身免疫性疾病,病理以慢性肝炎为特点;SLE肝损常表现在初发患者一过性ALT、AST、球蛋白、球蛋白升高,病理为非特异性肝损.球蛋白、γ球蛋白、免疫球蛋白G(IgG)在AIH中极显著高于SLE的肝损(P<0.001),抗双链DNA抗体(ds-DNA)在SLE肝损病人极显著高于AIH(P<0.001).结论:AIH肝病损严重,肝外病变多样,有多系统损害倾向,是完全有别于SLE肝损的独立疾病. Objective: To determine clinical manifestation and pathological changes by liver biopsy of autoimmune hepatitis(AIH). To detect its difference with the liver impairment of systemic lupus erythematosus(SLE). Method: The clinical manifestation and pathological changes by liver biopsy of 15 AIH patients were retrospectively compared with that of 20 SLE patients. Results: For AIH, clinically, there were extended elevation of ALT and AST, hyperglobulinemia, hypergammaglobulinemia and different kinds of antibodies. Patients usually had autoimmune diseases with pathologically change of typical chronic hepatitis. Liver damages in initial SLE included temporary elevation of ALT, AST, globulinemia, gammaglobulinemia. Its pathologic change was nonspecific damage. The levels of globulin, gammaglobulin in AIH were significantly higher than that of SLE liver impairment( P < 0.001) . Anti-dsDNA antibody of SLE liver impairment were significantly higher than that of AIH( P < 0.001). Conclusion: AIH has severe liver impairment with many other symptoms due to multi-systemic damage out of liver. AIH is a distinct disease and is completely different from liver damage of SLE.
作者 於强 王吉耀 姜林娣 张锦生 Yu Qiang Wang Jiyao Jiang Lindi,et al (Department of Internal Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032)
出处 《中国临床医学》 2001年第4期 366-368,共3页 Chinese Journal Of Clinical Medicine
关键词 自身免疫性慢性肝炎 系统性红斑狼疮 异质性 AIH Chronic hepatitis Autoimmune Systemic lupus erythematosus Heterogeneity
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  • 1牛秀凤,董怡.系统性红斑狼疮消化系统表现的临床分析[J].北京医学,1990,12(1):7-9. 被引量:12
  • 2Albert J. Czaja,Fabio Cassani,Michela Cataleta,Paolo Valentini,Francesco B. Bianchi. Antinuclear Antibodies and Patterns of Nuclear Immunofluorescence in Type 1 Autoimmune Hepatitis[J] 1997,Digestive Diseases and Sciences(8):1688~1696 被引量:1
  • 3A. L. W. F. Eddleston M.D.,FRCP. Immunogenetics of autoimmune chronic active hepatitis[J] 1993,Gastroenterologia Japonica(4):57~62 被引量:1

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