• 四川大學(xué)華西醫(yī)院感染性疾病中心(成都,610041);

【摘要】 目的  提高對自身免疫性肝病的認(rèn)識。 方法  報道一例自身免疫性肝炎/原發(fā)性膽汁性肝硬化重疊綜合征誤診為藥物性肝炎,并綜述相關(guān)文獻(xiàn)總結(jié)其臨床表現(xiàn)、診斷、治療及預(yù)后。 結(jié)果  自身免疫性肝病是一組以肝臟病理損害和肝功能異常為主要表現(xiàn)的自身免疫性疾病,可分為自身免疫性肝炎(autoinmmune hepatitis,AIH)和(primary biliary cirrhosis,PBC)及原發(fā)性硬化性膽管炎(primary sclerosing cholangitis,PSC)。由于無特異性的臨床表現(xiàn),容易漏診或誤診為藥物性肝炎,診斷主要依靠生化及免疫學(xué)檢查。AIH/PBC重疊綜合征的治療目前無成熟經(jīng)驗,主要藥物包括熊去氧膽酸(UDCA)、糖皮質(zhì)激素和免疫抑制劑等。 結(jié)論  對于不明原因的肝損害患者應(yīng)做免疫學(xué)篩查。

引用本文: 王娟,唐紅. 自身免疫性肝炎/原發(fā)性膽汁性肝硬化重疊綜合征誤診為藥物性肝炎一例. 華西醫(yī)學(xué), 2010, 25(11): 2062-2063. doi: 復(fù)制

1.  Gheorghe L, Iacob S, Gheorghe C, et al. Frequency and predictive factors for overlap syndrome between aunoimmune hepatitis and primary cholestatic liver disease[J]. Eur J Gastroenterol Hepatol, 2004, 16(6): 585-592.
2.  姚光弼, 范上達(dá), 廖光杰. 臨床肝臟病學(xué)[M]. 上海: 上??茖W(xué)技術(shù)出版社, 2004: 437-454, 483-497.
3.  賈繼東. 自身免疫性肝病的基本概念和診斷思路[J]. 中華肝臟病雜志, 2005, 13(1): 54.
4.  溫小鳳, 蔣忠勝. AIH-PBC重疊綜合征的診斷及治療[J]. Chinese Hepatology. 2009, 14(5): 426-427.
5.  Chazouillères O, Wendum D, Senfaty L, et al. Long tem outcome and response to therapy of primary biliary cirrhosis overlap syndrome[J]. J Hepatol, 2006, 44(2): 400-406.
6.  ltakura J, Izumi N, Nishimura Y, et al. Prospective randomized crossover trial of combination therapy with bezafibrate and UDCA for primary biliary cirrhosis[J]. Hepatol Res, 2004, 29(4): 216-212.
  1. 1.  Gheorghe L, Iacob S, Gheorghe C, et al. Frequency and predictive factors for overlap syndrome between aunoimmune hepatitis and primary cholestatic liver disease[J]. Eur J Gastroenterol Hepatol, 2004, 16(6): 585-592.
  2. 2.  姚光弼, 范上達(dá), 廖光杰. 臨床肝臟病學(xué)[M]. 上海: 上海科學(xué)技術(shù)出版社, 2004: 437-454, 483-497.
  3. 3.  賈繼東. 自身免疫性肝病的基本概念和診斷思路[J]. 中華肝臟病雜志, 2005, 13(1): 54.
  4. 4.  溫小鳳, 蔣忠勝. AIH-PBC重疊綜合征的診斷及治療[J]. Chinese Hepatology. 2009, 14(5): 426-427.
  5. 5.  Chazouillères O, Wendum D, Senfaty L, et al. Long tem outcome and response to therapy of primary biliary cirrhosis overlap syndrome[J]. J Hepatol, 2006, 44(2): 400-406.
  6. 6.  ltakura J, Izumi N, Nishimura Y, et al. Prospective randomized crossover trial of combination therapy with bezafibrate and UDCA for primary biliary cirrhosis[J]. Hepatol Res, 2004, 29(4): 216-212.