中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
1期
36-39
,共4页
庞淑珍%欧晓娟%石晓燕%王泰龄%段维佳%贾继东
龐淑珍%歐曉娟%石曉燕%王泰齡%段維佳%賈繼東
방숙진%구효연%석효연%왕태령%단유가%가계동
病因%临床特征%经皮肝穿刺活检%肝功能异常
病因%臨床特徵%經皮肝穿刺活檢%肝功能異常
병인%림상특정%경피간천자활검%간공능이상
Etiology%Clinical feature%Percutaneous needle biopsy of the liver%Abnormal liver function test
目的 探讨不明原因肝功能异常患者的临床和肝穿刺活检病理学特点,并对其诊断和鉴别诊断进行分析.方法 收集2008年1月-2009年12月以"肝功能异常原因待查"入院并行肝穿刺活检的患者,剔除病毒性肝炎、酒精性肝病、肝占位病变、结石所致胆管梗阻及抗线粒体抗体(AMA)和(或)抗线粒体抗体M2亚型(AMA-M2)阳性的原发性胆汁性肝硬化等比较容易诊断的疾病后,对最后诊断出的疾病种类及特点进行总结分析.结果 共88例符合上述入选标准,诊断共涉及15种疾病,居前3位的是药物性肝损害(DILI)[34.09%(30/88)]、自身免疫性肝病[22.73%(20/88)]和非酒精性脂肪性肝病(NAFLD)[12.50%(11/88)].结论 在原因不明的肝病中,DILI、自身免疫性肝病及NAFLD最常见,而遗传代谢性肝病等以前不被重视或未认识到的疾病也占相当的比例,应引起临床医师的重视.
目的 探討不明原因肝功能異常患者的臨床和肝穿刺活檢病理學特點,併對其診斷和鑒彆診斷進行分析.方法 收集2008年1月-2009年12月以"肝功能異常原因待查"入院併行肝穿刺活檢的患者,剔除病毒性肝炎、酒精性肝病、肝佔位病變、結石所緻膽管梗阻及抗線粒體抗體(AMA)和(或)抗線粒體抗體M2亞型(AMA-M2)暘性的原髮性膽汁性肝硬化等比較容易診斷的疾病後,對最後診斷齣的疾病種類及特點進行總結分析.結果 共88例符閤上述入選標準,診斷共涉及15種疾病,居前3位的是藥物性肝損害(DILI)[34.09%(30/88)]、自身免疫性肝病[22.73%(20/88)]和非酒精性脂肪性肝病(NAFLD)[12.50%(11/88)].結論 在原因不明的肝病中,DILI、自身免疫性肝病及NAFLD最常見,而遺傳代謝性肝病等以前不被重視或未認識到的疾病也佔相噹的比例,應引起臨床醫師的重視.
목적 탐토불명원인간공능이상환자적림상화간천자활검병이학특점,병대기진단화감별진단진행분석.방법 수집2008년1월-2009년12월이"간공능이상원인대사"입원병행간천자활검적환자,척제병독성간염、주정성간병、간점위병변、결석소치담관경조급항선립체항체(AMA)화(혹)항선립체항체M2아형(AMA-M2)양성적원발성담즙성간경화등비교용역진단적질병후,대최후진단출적질병충류급특점진행총결분석.결과 공88례부합상술입선표준,진단공섭급15충질병,거전3위적시약물성간손해(DILI)[34.09%(30/88)]、자신면역성간병[22.73%(20/88)]화비주정성지방성간병(NAFLD)[12.50%(11/88)].결론 재원인불명적간병중,DILI、자신면역성간병급NAFLD최상견,이유전대사성간병등이전불피중시혹미인식도적질병야점상당적비례,응인기림상의사적중시.
Objective To evaluate the clinical and histological features of patients with abnormal liver tests of unknown etiology, and then to investigate the diagnosis and differential diagnosis. Methods Patients with abnormal liver function test hospitalized and had liver biopsies during 2008-2009 constituted this retrospective study cohort. After excluding those patients diagnosed with hepatotropic viral hepatitis,space occupying lesions of the liver, alcoholic liver disease and obstruction of bile duct caused by stone or malignancy and AMA/AMA-M2 positive of primary biliary cirrhosis ( PBC ), the clinical and histological characteristics were evaluated. Results Out of the 180 patients who underwent liver biopsy, 88 patients were included in the present analysis. The final diagnosis involved 15 categories of diseases, with druginduced liver injury ( DILI ) [34. 09% ( 30/88 )], autoimmune liver diseases [22.73% ( 20/88 )], and nonalcoholic fatty liver disease (NAFLD) [12. 50% ( 11/88 )] being the most common causes, following by genetic and other rare diseases. Conclusion DILI, autoimmune liver disease and NAFLD were the most common causes of abnormal liver tests in these non-viral liver diseases. Some rare diseases such as hereditary metalbolic liver disease also represent a considerable proportion in patients with abnormal liver function test.
