实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
4期
396-399
,共4页
张敏%韩涛%聂彩云%王伟%杜卫杰%周淑芬%王棕覃%孙扬%丁贤%朱争艳
張敏%韓濤%聶綵雲%王偉%杜衛傑%週淑芬%王棕覃%孫颺%丁賢%硃爭豔
장민%한도%섭채운%왕위%두위걸%주숙분%왕종담%손양%정현%주쟁염
自身免疫性肝病%免疫球蛋白G4%临床特征
自身免疫性肝病%免疫毬蛋白G4%臨床特徵
자신면역성간병%면역구단백G4%림상특정
Autoimmune liver disease%Immunoglobulin G4%Clinical feature
探讨不同自身免疫性肝病患者血清免疫球蛋白G4（immunoglobulin G4，IgG4）水平差异，并分析不同血清IgG4水平的自身免疫性肝病患者临床特点的差异。方法收集自身免疫性肝病患者65例，其中自身免疫性肝炎（AIH）11例、原发性胆汁性肝硬化（primary biliary cirrhosis，PBC）47例及AIH与PBC重叠综合征7例。采用免疫散射比浊法检测三组患者血清IgG4水平，并分析三组之间血清IgG4水平的差异。根据血清IgG4水平的不同进行分组，分析不同血清IgG4水平的自身免疫性肝病患者临床特点的差异。对组间正态分布的计量资料的比较应用独立样本t检验，对非正态分布者采用Mann-Whitney U检验。计数资料的比较采用Fisher’s确切概率法。结果 AIH患者血清 IgG4水平为642.2 mg/L （97.7 mg/L~1687.0 mg/L），高于 PBC 患者[153.9 mg/L（78.9 mg/L~400.3 mg/L），P=0.076]及重叠综合征患者[229.9 mg/L（154.9 mg/L~417.9 mg/L），P=0.388]，无统计学差异。其中3例AIH患者血清IgG4水平异常升高（≥1350 mg/L），与血清IgG4水平较低的8例AIH患者比，IgG4水平和IgG4/IgG比值较高，差异具有统计学意义（P<0.05）；3例血清IgG4水平≥1350 mg/L的AIH患者均合并2型糖尿病，其中1例合并类风湿性关节炎，而其他8例AIH患者未合并其他自身免疫性或代谢性疾病；血清IgG4水平较高（IgG4水平≥200 mg/L）的14例PBC患者与IgG4水平较低的33例PBC患者比，血清总胆红素水平较高[（45.09±74.85）μmol/L 对（26.38±23.03）μmol/L，P=0.05]。结论与PBC及PBC与AIH 重叠综合征患者比，AIH患者血清IgG4水平较高。血清IgG4水平较高的AIH患者可能较易合并其他自身免疫性或代谢性疾病。
探討不同自身免疫性肝病患者血清免疫毬蛋白G4（immunoglobulin G4，IgG4）水平差異，併分析不同血清IgG4水平的自身免疫性肝病患者臨床特點的差異。方法收集自身免疫性肝病患者65例，其中自身免疫性肝炎（AIH）11例、原髮性膽汁性肝硬化（primary biliary cirrhosis，PBC）47例及AIH與PBC重疊綜閤徵7例。採用免疫散射比濁法檢測三組患者血清IgG4水平，併分析三組之間血清IgG4水平的差異。根據血清IgG4水平的不同進行分組，分析不同血清IgG4水平的自身免疫性肝病患者臨床特點的差異。對組間正態分佈的計量資料的比較應用獨立樣本t檢驗，對非正態分佈者採用Mann-Whitney U檢驗。計數資料的比較採用Fisher’s確切概率法。結果 AIH患者血清 IgG4水平為642.2 mg/L （97.7 mg/L~1687.0 mg/L），高于 PBC 患者[153.9 mg/L（78.9 mg/L~400.3 mg/L），P=0.076]及重疊綜閤徵患者[229.9 mg/L（154.9 mg/L~417.9 mg/L），P=0.388]，無統計學差異。其中3例AIH患者血清IgG4水平異常升高（≥1350 mg/L），與血清IgG4水平較低的8例AIH患者比，IgG4水平和IgG4/IgG比值較高，差異具有統計學意義（P<0.05）；3例血清IgG4水平≥1350 mg/L的AIH患者均閤併2型糖尿病，其中1例閤併類風濕性關節炎，而其他8例AIH患者未閤併其他自身免疫性或代謝性疾病；血清IgG4水平較高（IgG4水平≥200 mg/L）的14例PBC患者與IgG4水平較低的33例PBC患者比，血清總膽紅素水平較高[（45.09±74.85）μmol/L 對（26.38±23.03）μmol/L，P=0.05]。結論與PBC及PBC與AIH 重疊綜閤徵患者比，AIH患者血清IgG4水平較高。血清IgG4水平較高的AIH患者可能較易閤併其他自身免疫性或代謝性疾病。
탐토불동자신면역성간병환자혈청면역구단백G4（immunoglobulin G4，IgG4）수평차이，병분석불동혈청IgG4수평적자신면역성간병환자림상특점적차이。방법수집자신면역성간병환자65례，기중자신면역성간염（AIH）11례、원발성담즙성간경화（primary biliary cirrhosis，PBC）47례급AIH여PBC중첩종합정7례。채용면역산사비탁법검측삼조환자혈청IgG4수평，병분석삼조지간혈청IgG4수평적차이。근거혈청IgG4수평적불동진행분조，분석불동혈청IgG4수평적자신면역성간병환자림상특점적차이。대조간정태분포적계량자료적비교응용독립양본t검험，대비정태분포자채용Mann-Whitney U검험。계수자료적비교채용Fisher’s학절개솔법。결과 AIH환자혈청 IgG4수평위642.2 mg/L （97.7 mg/L~1687.0 mg/L），고우 PBC 환자[153.9 mg/L（78.9 mg/L~400.3 mg/L），P=0.076]급중첩종합정환자[229.9 mg/L（154.9 mg/L~417.9 mg/L），P=0.388]，무통계학차이。기중3례AIH환자혈청IgG4수평이상승고（≥1350 mg/L），여혈청IgG4수평교저적8례AIH환자비，IgG4수평화IgG4/IgG비치교고，차이구유통계학의의（P<0.05）；3례혈청IgG4수평≥1350 mg/L적AIH환자균합병2형당뇨병，기중1례합병류풍습성관절염，이기타8례AIH환자미합병기타자신면역성혹대사성질병；혈청IgG4수평교고（IgG4수평≥200 mg/L）적14례PBC환자여IgG4수평교저적33례PBC환자비，혈청총담홍소수평교고[（45.09±74.85）μmol/L 대（26.38±23.03）μmol/L，P=0.05]。결론여PBC급PBC여AIH 중첩종합정환자비，AIH환자혈청IgG4수평교고。혈청IgG4수평교고적AIH환자가능교역합병기타자신면역성혹대사성질병。
To study the differences of serum IgG4 levels in various autoimmune liver diseases and to analyze the clinical characterization of patients with high serum IgG4 levels. Methods 65 patients with autoimmune liver diseases were enrolled for this study including 11 patients with autoimmune hepatitis (AIH),47 patients with primary biliary cirrhosis (PBC) and 7 patients with overlap syndrome of AIH and PBC. The serum IgG4 levels was detected by immuno-scatter turbidmetry. The differences of serum IgG4 levels in the three groups were studied. The clinical features of patients with autoimmune liver disease were analyzed according to their serum IgG4 levels. The significance of inter-group differences of measurement data was assessed by Student’s t-test or Mann-Whitney U test and enumeration data by Fisher’s exact test. Results The serum IgG4 levels in patients with AIH was 642.2 mg/L(97.7 mg/L~1687.0 mg/L),a little higher than in patients with PBC [153.9 mg/L(78.9 mg/L~400.3 mg/L),P=0.076] and in with overlap syndrome [229.9 mg/L(154.9 mg/L ~417.9 mg/L),P=0.388];Three patients with AIH had high serum IgG4 levels (≥1350 mg/L) out of 11 patients with AIH. The ratio of IgG4/IgG was higher in the three patients with higher as compared to 8 with relatively low serum IgG4 levels (P﹤0.05);The three patients with elevated IgG4 levels had diabetes mellitus type 2 and one of them was also complicated with rheumatoid arthritis,whereas the other 8 patients with low serum IgG4 levels were not;14 patients with PBC with higher serum IgG4 levels (≥200 mg/L) had higher total serum bilirubin levels as com-pared to those in 33 patients with relatively low serum IgG4 levels [(45.09 ±74.85)μmol/L vs.(26.38 ±23.03)μmol/L,P=0.05)]. Conclusion Compared with patients with PBC or overlap syndrome of AIH and PBC,the pa-tients with AIH have a higher serum IgG4 levels. The patients with AIH with high serum IgG4 levels might be complicated with other autoimmune or metabolic diseases.
