实用肝脏病杂志 ›› 2015, Vol. 18 ›› Issue (5): 504-507.doi: 10.3969/j.issn.1672-5069.2015.05.014

• 药物性肝损伤 • 上一篇    下一篇

急性药物性肝损伤患者肝病相关抗体阳性率调查及其临床意义

卢丹,段志军   

  1. 350005福州市 福建医科大学附属第一医院(卢丹);大连医科大学附属第一医院消化内科(段志军)
  • 收稿日期:2015-03-02 出版日期:2015-09-10 发布日期:2016-02-18
  • 通讯作者: 段志军,E-mail:duanzhijun_5963@163.com E-mail:ludan_4107@163.com
  • 作者简介:卢丹,女,30岁,医学硕士,住院医师。E-mail:ludan_4107@163.com

Prevalence of liver disease-related antibodies in patients with acute drug-induced liver injury and its clinical significance

Lu Dan,Duan Zhijun   

  1. First Affiliated Hospital,Fujian Medical University,Fuzhou 350005, Fujian Province
  • Received:2015-03-02 Online:2015-09-10 Published:2016-02-18

摘要: 目的 分析急性药物性肝损伤患者肝病相关抗体阳性情况。方法 复习2002年6月~2012年3月大连医科大学附属第一医院住院患者中诊断为急性药物性肝损伤患者的资料,分析肝病相关抗体的阳性情况。结果 104例患者中肝病相关抗体阳性率为54.81%,其中ANA 45.19%,ASMA 14.42%;ANA高滴度(≥1:320)的患者占ANA阳性患者的34.04%;2种抗体同时阳性的占阳性患者的26.32%,以ANA和ASMA阳性最常见;3种抗体同时阳性的占阳性患者的8.77%,以ANA/AMA/AMA-M2同时阳性多见;女性患者抗体阳性率高于男性,肝细胞损伤型患者抗体阳性率高于胆汁淤积型和混合型患者(P<0.05)。结论 急性药物性肝损伤患者肝病相关抗体的阳性率高达一半以上,尤其是女性、肝细胞损伤型患者,应注意鉴别。

关键词: 药物性肝损伤, 肝病相关抗体, 阳性率

Abstract: Objective To explore the prevalence of serial autoimmune antibody associated with liver diseases in patients with acute drug-induced liver injury(ADILI). Methods A retrospective analysis was conducted over 104 patients with ADILI,admitted to the First Affiliated Hospital of Dalian Medical University from June 2002 to March 2012,and the prevalence of liver disease-related autoimmune antibody were analyzed. Results The positive rate of liver disease-related autoantibodies in 104 cases was 54.81%;Among the positive patients,ANA was positive in 47 cases (45.19%) and ASMA in 15 cases (14.42%);The high ANA titer (≥1:320) accounted for 34.04% in ANA-positive cases;Two antibodies positive accounted for 26.32% in 57 antibody-positive cases,and ANA/ASMA was the most common;Serum ANA/AMA/AMA-M2 positive accounted for 8.77% in 57 antibody-positive cases;Female had higher antibody positive rate than male did,and the antibody positive rate was higher in patients with hepatocellular injury pattern than those in cholestatic or mixed pattern. Conclusions The prevalence of liver disease-related antibodies was positive in more than half the patients with ADILI,especially common in females and cases of hepatocellular injury pattern. Clinician should keep an open eye on differential diagnosis.

Key words: Drug-induced liver injury, Liver disease-related antibodies, Prevalence