Objective To analyze the clinical characteristics of autoimmune liver disease (ALD)patients in southwest China. Methods A total of 436 patients with ALD were enrolled,including 211 cases with autoimmune hepatitis (AIH), 145 cases with primary biliary cirrhosis (PBC),and 80 cases with AIH-PBC overlap syndrome (OS)at the department of infectious diseases,Southwest Hospital,during the past 10 years. Characteristics of general data,clinical manifestations, biochemical indicators,autoantibodies and pathology observation in liver biopsy were analyzed. Results Majority of patients were female,with an average age of 49.7 years old. Clinical manifestations were similar. However,there was significant differences among 3 groups in ALT,GGT,and TBIL (P<0.05 ). Major autoantibodies were ANA in AIH group and AMA in PBC group (especially AMA-M2 ),while all 3 kinds of autoantibodies as mentioned were found in OS group. Pathology results confirmed ALD by manifestations as followed:liver cell degeneration and necrosis,inflammatory cell infiltration,bile duct inflammation and fibrous hyperplasia. Conclusion In southwest region of China,most of ALD patients were female and middle-aged,especially women about 50 years old in peri-menopausal period. Serum biochemical indexes (ALT,GGT),immunoglobulin subtypes,autoantibodies detections and liver biopsy were essential to distinguish ALD and of great value in diagnosis of ALD.%目的：分析西南地区各型自身免疫性肝病的临床特点，以期提高早期诊断率。方法回顾性分析比较第三军医大学西南医院收治的436例自身免疫性肝病患者的一般资料、临床表现、血清生化学、自身抗体、肝组织病理等指标的差异，其中包括自身免疫性肝炎（AIH）211例，原发性胆汁性肝硬化（PBC）145例，自身免疫性肝炎-原发性胆汁性肝硬化重叠综合征（OS）80例。结果患者平均发病年龄为49．7岁，男女比为1∶6；各组临床表现无显著差异；各组 ALT、GGT、TBil等血清学指标差异有统计学意义（P＜0．05）；AIH 组血清自身抗体以ANA（＋）为主，PBC 组中以AMA（＋）、AMA-M2（＋）为主，OS组兼有AIH 及PBC自身抗体的特点；各组肝组织病理主要表现为肝细胞变性、坏死、炎细胞浸润、小胆管炎症及纤维增生。结论在我国西南地区AIH、PBC、OS多为50岁左右的围绝经期女性。综合分析临床表现、血清生化学指标、免疫球蛋白亚型、自身抗体等指标有助于确诊不同类型的自身免疫性肝病，肝活组织检查为重要的辅助诊断手段。
展开▼
