关键词: 自身免疫性肝炎, 老年人, 自身抗体, 肾脏功能, β-球蛋白

Abstract: Objective To explore the clinical characteristics of elderly patients with autoimmune hepatitis （AIH）. Methods 133 patients with AIH in our hospital between Jan.2005 and Dec.2015 were selected in this study. The age was 13 to 83 years-old with mean age of（55.20±12.91） years old,and the male were 20 and female were 113 cases;Patients younger than 60 years old（non-elderly group） were 85 cases,and elderly group older than 60 were 48 cases. Statistically analysis was applied to compare the clinical manifestations,biochemical indicators,immunological indexes in the two groups. Results Women were significantly more than men in patients with AIH in this study,and the coexistence of Sjogren's syndrome in non- elderly group was 20.0%,and 31.3% in the elderly group,autoimmune thyroiditis were 10.6% and 8.3%,and rheumatoid arthritis were 4.7% and 10.4% in the two groups;serum ALT,AST and ALP levels increased at a low levels,serum GGT levels increased significantly,and blood γ-globulin and IgG increased at a maximum limit of normal references;the positive rates of ANA were 80.5% in elderly group and 77.0% in non-elderly group,the AMA were 51.7% and 55.9%, the SSA were 23.3% and 15.2%,the ENA were 8.3% and 7.7%,and the DsDNA was only positive in non-elderly group （6.3%）,and the SLA/LP,LC-1 and LKM did not check out in the two groups;MCV and average of MCH in the elderly group were obviously higher than those in the non-elderly group （P<0.05）;serum Cr,urea and Cys-C levels in the elderly group was significantly higher than in the non-elderly group,and the differences between the two groups was statistically significant（P<0.01）;serum β-globulin in the non-elderly group was much higher than in the elderly group（P<0.01）. Conclusion The elderly AIH patients is similar to the non-elderly group in clinical manifestations, complicated by extrahepatic incidence of autoimmune diseases,liver biochemistry,autoantibodies,γ-globulin and IgG levels;But the MCV and MCH in the elderly group are significantly larger,suggesting that the elderly patients may be deteriorated by autoimmune gastritis;the rise of serum Cys-C in elderly patients suggests that they may be with kidney damage and serum β-globulin levels increase at a low levels in the non-elderly patients,hinting that they are prone to intrahepatic cholestasis;DsDNA is restricted to the non-elderly patients,implying that they are easy to have multiple autoimmune organ diseases.

Key words: Autoimmune hepatitis, Elderly, Auto antibodies, Renal function, β-globulin