自身免疫性肝炎-原发性胆汗性肝硬化重叠综合征的临床特点及诊断分析

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...

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Bibliographic Details
Published in临床肝胆病杂志 Vol. 30; no. 5; pp. 413 - 416
Main Author 李冰 邵清 牛小霞 张健 陈国凤
Format Journal Article
LanguageChinese
Published 解放军302医院 肝纤维化诊疗中心,北京,100039 2014
Subjects
肝炎,自身免疫性
肝硬化,胆汁性
肝硬化,胆汁性
liver cirrhosis,biliary
hepatitis,autoimmune
肝炎,自身免疫性
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ISSN1001-5256
DOI10.3969/j.issn.1001-5256.2014.05.007

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Summary: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。
Bibliography:hepatitis,autoimmune;liver cirrhosis,biliary
LI Bing, SHAO Qing, NIU Xiaoxia, et al. （Liver Fibrosis Diagnosis and Treatment Center, 302 Hospital of PIA, Beijing 100039, China）
Objective To analyze the clinical features and laboratory test results of patients with autoimmune hepatitis （AIH）-primary biliary 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 admission 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′
ISSN:1001-5256
DOI:10.3969/j.issn.1001-5256.2014.05.007