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目的探讨自身免疫性肝病患者肝功能指标与自身抗体的变化及临床意义。方法选择临床已确诊的自身免疫性肝病25例。其中自身免疫性肝炎(AIH)11例,原发性胆汁性肝硬化(PBC)14例,另取30例正常人对照。采用日立7600-20全自动生化分析仪,Laica荧光显微镜,测定肝功能指标及各种自身抗体。结果 AIH、PBC患者组生化指标均有三项及三项以上升高,在AIH时ALT、AST升高明显而PBS则轻到中度升高。PBS时以GGT、TAB、ALP升高最为明显。AIH组患者抗核抗体(ANA)阳性率达73%,平滑肌抗体(SMA)阳性率达54%。14例PBC患者组ANA、线粒体抗体(AMA)及线粒体M2抗体(AMAM2)阳性率达100%。结论血清肝功能指标及各种自身抗体联合检测对自身免疫性肝病诊断、合理用药、判断预后有着极其重要的意义。
Objective To investigate the changes of liver function indexes and autoantibodies in patients with autoimmune liver disease and its clinical significance. Methods 25 cases of clinically diagnosed autoimmune liver disease were selected. Including autoimmune hepatitis (AIH) in 11 cases, 14 cases of primary biliary cirrhosis (PBC), another 30 cases of normal controls. Using Hitachi 7600-20 automatic biochemical analyzer, Laica fluorescence microscope, determination of liver function indicators and a variety of autoantibodies. Results The biochemical indexes of AIH and PBC patients were all higher than those of three patients. The levels of ALT and AST increased significantly in AIH and mild to moderate in PBS. PBS to GGT, TAB, ALP increased the most obvious. In the AIH group, the positive rate of antinuclear antibody (ANA) was 73% and the positive rate of smooth muscle antibody (SMA) was 54%. The positive rate of ANA, mitochondrial antibody (AMA) and mitochondrial M2 antibody (AMAM2) was 100% in 14 PBC patients. Conclusion Serum liver function indicators and various autoantibodies combined detection of autoimmune liver disease diagnosis, rational use of drugs, to determine the prognosis is extremely important.