临床肝胆病杂志Issue(5)：413-416,4.DOI:10.3969/j.issn.1001-5256.2014.05.007
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
Clinical features and diagnosis of autoimmune hepatitis-primary biliary cirrhosis overlap syndrome
李冰 1邵清 1牛小霞 1张健 1陈国凤1
作者信息
- 1. 解放军302医院 肝纤维化诊疗中心，北京 100039
- 折叠
摘要
Abstract
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.关键词
肝炎,自身免疫性/肝硬化,胆汁性Key words
hepatitis,autoimmune/liver cirrhosis,biliary分类
医药卫生引用本文复制引用
李冰,邵清,牛小霞,张健,陈国凤..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[J].临床肝胆病杂志,2014,(5):413-416,4.
