中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2015年
2期
90-94
,共5页
高莉%章丽娜%何彩琴%赵晓蕾%刘玉兰
高莉%章麗娜%何綵琴%趙曉蕾%劉玉蘭
고리%장려나%하채금%조효뢰%류옥란
肝炎,自身免疫性%共病现象%自身免疫疾病%预后
肝炎,自身免疫性%共病現象%自身免疫疾病%預後
간염,자신면역성%공병현상%자신면역질병%예후
Hepatitis,autoimmune%Comorbidity%Autoimmune diseases%Prognosis
目的 研究原发性胆汁性肝硬化(PBC)、自身免疫性肝炎(AIH)、原发性硬化性胆管炎(PSC)患者中出现其他自身免疫病的比例,并探讨其对预后的影响.方法 收集1994年1月至2014年3月各专科收治的全部自身免疫性肝病(AILD)患者资料共232例,分析对比PBC、AIH和PSC患者合并其他自身免疫病的种类和例数.使用Cox回归模型分析合并其他自身免疫病对AILD预后的影响.结果 232例AILD患者中,PBC患者135例,其中合并干燥综合征(SS) 64例,系统性红斑狼疮(SLE)7例,类风湿关节炎(RA)7例,系统性硬化症(SSc)9例,多发性肌炎(PM)和(或)皮肌炎3例,CD 1例;AIH患者55例,其中合并SS 19例,SLE 10例,RA 1例,SSc 2例,PM和(或)皮肌炎2例;PSC患者24例,其中合并UC 7例,CD 1例,RA 1例;PBC AIH重叠综合征患者18例,其中合并SS 5例,RA1例.调整性别、年龄、病程及药物干预等因素后发现,相比单纯PBC患者,PBC合并SS发生肺间质纤维化的风险明显增加(OR=34.0,95％CI:8.9～130.1).合并其他自身免疫病并未显著影响AILD的预后,包括死亡、肝移植,及肝硬化并发症.结论 AILD合并其他自身免疫病,如SS、SLE、SSc、RA等较为常见.PBC合并SS是发生肺间质纤维化的危险因素,合并其他自身免疫病不独立影响AILD的预后.
目的 研究原髮性膽汁性肝硬化(PBC)、自身免疫性肝炎(AIH)、原髮性硬化性膽管炎(PSC)患者中齣現其他自身免疫病的比例,併探討其對預後的影響.方法 收集1994年1月至2014年3月各專科收治的全部自身免疫性肝病(AILD)患者資料共232例,分析對比PBC、AIH和PSC患者閤併其他自身免疫病的種類和例數.使用Cox迴歸模型分析閤併其他自身免疫病對AILD預後的影響.結果 232例AILD患者中,PBC患者135例,其中閤併榦燥綜閤徵(SS) 64例,繫統性紅斑狼瘡(SLE)7例,類風濕關節炎(RA)7例,繫統性硬化癥(SSc)9例,多髮性肌炎(PM)和(或)皮肌炎3例,CD 1例;AIH患者55例,其中閤併SS 19例,SLE 10例,RA 1例,SSc 2例,PM和(或)皮肌炎2例;PSC患者24例,其中閤併UC 7例,CD 1例,RA 1例;PBC AIH重疊綜閤徵患者18例,其中閤併SS 5例,RA1例.調整性彆、年齡、病程及藥物榦預等因素後髮現,相比單純PBC患者,PBC閤併SS髮生肺間質纖維化的風險明顯增加(OR=34.0,95％CI:8.9～130.1).閤併其他自身免疫病併未顯著影響AILD的預後,包括死亡、肝移植,及肝硬化併髮癥.結論 AILD閤併其他自身免疫病,如SS、SLE、SSc、RA等較為常見.PBC閤併SS是髮生肺間質纖維化的危險因素,閤併其他自身免疫病不獨立影響AILD的預後.
목적 연구원발성담즙성간경화(PBC)、자신면역성간염(AIH)、원발성경화성담관염(PSC)환자중출현기타자신면역병적비례,병탐토기대예후적영향.방법 수집1994년1월지2014년3월각전과수치적전부자신면역성간병(AILD)환자자료공232례,분석대비PBC、AIH화PSC환자합병기타자신면역병적충류화례수.사용Cox회귀모형분석합병기타자신면역병대AILD예후적영향.결과 232례AILD환자중,PBC환자135례,기중합병간조종합정(SS) 64례,계통성홍반랑창(SLE)7례,류풍습관절염(RA)7례,계통성경화증(SSc)9례,다발성기염(PM)화(혹)피기염3례,CD 1례;AIH환자55례,기중합병SS 19례,SLE 10례,RA 1례,SSc 2례,PM화(혹)피기염2례;PSC환자24례,기중합병UC 7례,CD 1례,RA 1례;PBC AIH중첩종합정환자18례,기중합병SS 5례,RA1례.조정성별、년령、병정급약물간예등인소후발현,상비단순PBC환자,PBC합병SS발생폐간질섬유화적풍험명현증가(OR=34.0,95％CI:8.9～130.1).합병기타자신면역병병미현저영향AILD적예후,포괄사망、간이식,급간경화병발증.결론 AILD합병기타자신면역병,여SS、SLE、SSc、RA등교위상견.PBC합병SS시발생폐간질섬유화적위험인소,합병기타자신면역병불독립영향AILD적예후.
Objective To study the probability of other autoimmune diseases in primary biliary cirrhosis (PBC),autoimmune hepatitis (AIH) and primary sclerosing cholangitis (PSC) and explore its effects on the prognosis.Methods From January 1994 to March 2014,the data of 232 patients with autoimmune liver diseases (AILD) were collected.The type and case number of coexisting with other autoimmune diseases of patients with PBC,AIH and PSC were analyzed and compared.Cox regression model was performed to analyze the effects of coexisting with autoimmune diseases on the prognosis of AILD.Results Among 135 PBC patients,there were 64 cases that coexisted with Sjogren's syndrome (SS),seven cases with systemic lupus erythematosus (SLE),seven cases with rheumatoid arthritis (RA),nine cases with systemic sclerosis (SSc),three cases with polymyositis and/or dermatomyositis (PM/DM) and one case with Crohn's disease.Among 55 AIH patients,threre were 19 cases that coexisted with SS,10 cases with SLE,one case with RA,two cases with SSc and two cases with PM/ DM.Among 24 PSC patients,there were seven cases combined with ulceric colitis,one case with Crohn's disease and one case with RA.Among 18 patients with PBC AIH overlap syndrome,there were five cases with SS and one case with RA.Compared with PBC patients,the risk of pulmonary interstitial fibrosis increased in PBC patiento coexisting with SS (OR =34.0,95 ％ CI 8.9 to 130.1).After gender,age,disease course and medicine intervention were adjusted,the prognosis of AILD which included death,liver transplantation and liver cirrhosis complications was not affected by the coexistence with other autoimmune diseases.Conclusions AILD patients coexisting with other autoimmune diseases is common,most of which are SS,SLE,SSc and RA.PBC patients coexisting with SS is the risk factor of pulmonary interstitial fibrosis,and coexisting with other autoimmune disease does not independently affect the prognosis of AILD.
