摘要
目的观察自身免疫性肝病的临床病理特点,并探讨对其早期诊断的方法。方法采用国际自身免疫性肝炎小组新修订的描述性诊断标准和计分系统,对11例自身免疫性肝病患者,进行临床资料及肝穿刺标本的光镜和免疫表型观察。结果11例患者中单纯自身免疫性肝炎(AIH)4例(36%),单纯原发性胆汁性肝硬化(PBC)6例(55%),AIH-PBC重叠综合征1例(9%);其中女性10例,以中老年为主;肝功能改变以血清碱性磷酸酶(ALP)和γ-谷氨酰转肽酶(γ-GT)升高为主;肝组织病理学改变以慢性肝炎为特点,其界面炎及汇管区周围淋巴细胞、浆细胞浸润明显,CD138免疫组化染色显示自身免疫性肝病组浆细胞数目明显多于慢性乙型病毒性肝炎组,分别为(7.64±3.85)个/HP和(3.73±1.79)个/HP,(P<0.01)。结论自身免疫性肝病具有组织形态及免疫组织化学特点,浆细胞数目增多对自身免疫性肝病的诊断有帮助。
Objective To analyze the clinical and histopathological characteristics of autoimmune liver disease （ALD）, and to explore the diagnostic criteria. Methods By using descriptive diagnosis standard and scoring system which was newly revised by the International Autoimmune Hepatitis Group Report, 11 cases of autoimmune liver disease were chosen to do immunophenotype observation of clinical information and liver puncture samples. Results There were 4 cases （36%） of pure AIH patients and 6 cases（55%） of pure PBC patients among the cases,the rest 1 case（9%） was over-lapped synthesis; the female patients with autoimmune hepatopathy was 10 cases,ALD mainly affects middle and old aged female patients;the levels of serum alkaline phos- phatase （ALP） and serum gamma glutamy transpeptidase （r-GT） were very high;the main histopathological change was characterized of chronic hepatitis, and the infiltration of lymphocytes and plasma cells in the portal tract or periportal area were found in the liver biopsie; the number of plasma cells in the ALD group were significantly higher than that in the CHB group[（7.64± 3.85）/HP and（3.73±1.79）/HP,P〈0. 01]. Conclusion Autoimmune liver disease relatively has the feature of morphology and immunohistochemistry,the increase of plasma cells in liver biopsy is helpful for diagnosis of ALD.
出处
《江西医学院学报》
2009年第2期72-75,共4页
Acta Academiae Medicinae Jiangxi
