临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2014年
5期
413-416
,共4页
李冰%邵清%牛小霞%张健%陈国凤
李冰%邵清%牛小霞%張健%陳國鳳
리빙%소청%우소하%장건%진국봉
肝炎,自身免疫性%肝硬化,胆汁性
肝炎,自身免疫性%肝硬化,膽汁性
간염,자신면역성%간경화,담즙성
hepatitis,autoimmune%liver cirrhosis,biliary
目的:分析自身免疫性肝炎(AIH)-原发性胆汁性肝硬化(PBC)重叠综合征患者临床特点、实验室结果、诊断正确率及时长。方法选取2009年1月至2013年6月经过肝活组织病理检查明确诊断为AIH-PBC重叠综合征的患者53例,对照组为AIH及PBC患者各53例。对患者的临床表现、实验室结果及入院后诊断情况进行回顾分析。正态分布的定量资料采用单因素方差分析对各组间进行比较,两两比较采用SNK-q检验。定性资料采用R ×C列联表法进行各组间比较,两两比较采用Scheffe可信区间法。结果53例AIH-PBC重叠综合征患者ALT为(173.65±52.08)U/L,血清TBil为(38.07±6.82)μmol/L,ALP为(293.81±28.89)U/L,GGT为(57.57±78.84)U/L。其中ALP较两个对照组差异有统计学意义;血清免疫球蛋白IgM为(3.33±2.12) g/L,较两个对照组差异具有统计学意义。自身抗体中抗线粒体抗体M2亚型(AMA-M2)(27/53)较两对照组差异具有统计学意义;未经肝活组织检查诊断正确率(52.83%)最低、入院后明确诊断需要时间最长[(8±7.7)d]。结论 AIH-PBC 重叠综合征临床表现更类似于PBC,但生化检查结果更类似于AIH,AIH-PBC 重叠综合征兼有AIH和PBC的双重特点。
目的:分析自身免疫性肝炎(AIH)-原髮性膽汁性肝硬化(PBC)重疊綜閤徵患者臨床特點、實驗室結果、診斷正確率及時長。方法選取2009年1月至2013年6月經過肝活組織病理檢查明確診斷為AIH-PBC重疊綜閤徵的患者53例,對照組為AIH及PBC患者各53例。對患者的臨床錶現、實驗室結果及入院後診斷情況進行迴顧分析。正態分佈的定量資料採用單因素方差分析對各組間進行比較,兩兩比較採用SNK-q檢驗。定性資料採用R ×C列聯錶法進行各組間比較,兩兩比較採用Scheffe可信區間法。結果53例AIH-PBC重疊綜閤徵患者ALT為(173.65±52.08)U/L,血清TBil為(38.07±6.82)μmol/L,ALP為(293.81±28.89)U/L,GGT為(57.57±78.84)U/L。其中ALP較兩箇對照組差異有統計學意義;血清免疫毬蛋白IgM為(3.33±2.12) g/L,較兩箇對照組差異具有統計學意義。自身抗體中抗線粒體抗體M2亞型(AMA-M2)(27/53)較兩對照組差異具有統計學意義;未經肝活組織檢查診斷正確率(52.83%)最低、入院後明確診斷需要時間最長[(8±7.7)d]。結論 AIH-PBC 重疊綜閤徵臨床錶現更類似于PBC,但生化檢查結果更類似于AIH,AIH-PBC 重疊綜閤徵兼有AIH和PBC的雙重特點。
목적:분석자신면역성간염(AIH)-원발성담즙성간경화(PBC)중첩종합정환자림상특점、실험실결과、진단정학솔급시장。방법선취2009년1월지2013년6월경과간활조직병리검사명학진단위AIH-PBC중첩종합정적환자53례,대조조위AIH급PBC환자각53례。대환자적림상표현、실험실결과급입원후진단정황진행회고분석。정태분포적정량자료채용단인소방차분석대각조간진행비교,량량비교채용SNK-q검험。정성자료채용R ×C렬련표법진행각조간비교,량량비교채용Scheffe가신구간법。결과53례AIH-PBC중첩종합정환자ALT위(173.65±52.08)U/L,혈청TBil위(38.07±6.82)μmol/L,ALP위(293.81±28.89)U/L,GGT위(57.57±78.84)U/L。기중ALP교량개대조조차이유통계학의의;혈청면역구단백IgM위(3.33±2.12) g/L,교량개대조조차이구유통계학의의。자신항체중항선립체항체M2아형(AMA-M2)(27/53)교량대조조차이구유통계학의의;미경간활조직검사진단정학솔(52.83%)최저、입원후명학진단수요시간최장[(8±7.7)d]。결론 AIH-PBC 중첩종합정림상표현경유사우PBC,단생화검사결과경유사우AIH,AIH-PBC 중첩종합정겸유AIH화PBC적쌍중특점。
Objective To analyze the clinical features and laboratory test results of patients with autoimmune hepatitis (AIH)-primary bil-iary cirrhosis (PBC)overlap syndrome,as well as their correct diagnosis rate and time to diagnosis.Methods Fifty-three patients who were diagnosed by liver biopsy as having AIH-PBC overlap syndrome from January 2009 to June 2013 were selected as subjects;53 AIH patients and 53 PBC patients were selected as control groups.Their clinical manifestations,laboratory test results,and diagnosis on admis-sion were retrospectively analyzed.Comparison of normally distributed quantitative data between groups was made by one-way analysis of variance,and multiple comparisons were made by SNK-q test;comparison of qualitative data between groups was made using R ×C contin-gency table,and multiple comparisons were made by Scheffe′s confidence interval test.Results The 53 patients with AIH-PBC overlap syndrome had a serum alanine aminotransferase level of 173.65 ±52.08 U/L,a serum total bilirubin level of 38.07 ±6.82 μmol/L,a ser-um alkaline phosphatase (ALP)level of 293.81 ±28.89 U/L,and a serum gamma-glutamyl transpeptidase level of 57.57 ±78.84 U/L. ALP showed significant difference between the patients with AIH-PBC overlap syndrome and control groups.The serum level of immuno-globulin Min overlap syndrome patients was 3.33 ±2.12 g/L,which was significantly different from those of two control groups.Of the 53 overlap syndrome patients,27 were positive for anti-mitochondrial antibody-M2,and the positive rate was significantly different from those of two control groups.Without liver biopsy,the correct diagnosis rate was the lowest (52.83%),and it took the longest time (8 ±7.7 d) to confirm the diagnosis on admission.Conclusion The clinical manifestations of patients with AIH-PBC overlap syndrome are more simi-lar to those of PBC patients,but their biochemical test results are more similar to those of AIH patients.AIH-PBC overlap syndrome has the clinical features of both AIH and PBC.