自身免疫性肝炎/原发性胆汁性肝硬化重叠综合征误诊为药物性肝炎一例_West China Medical Journal

Authors：

王娟 ,  唐红

Corresponding author：

唐红, Email: wwjj199@126.com

Keywords：

自身免疫性肝炎; 原发性胆汁性肝硬化; 药物性肝炎

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【摘要】　目的　提高对自身免疫性肝病的认识。　方法　报道一例自身免疫性肝炎/原发性胆汁性肝硬化重叠综合征误诊为药物性肝炎，并综述相关文献总结其临床表现、诊断、治疗及预后。　结果　自身免疫性肝病是一组以肝脏病理损害和肝功能异常为主要表现的自身免疫性疾病，可分为自身免疫性肝炎（autoinmmune hepatitis，AIH）和（primary biliary cirrhosis，PBC）及原发性硬化性胆管炎（primary sclerosing cholangitis，PSC）。由于无特异性的临床表现，容易漏诊或误诊为药物性肝炎，诊断主要依靠生化及免疫学检查。AIH/PBC重叠综合征的治疗目前无成熟经验，主要药物包括熊去氧胆酸（UDCA）、糖皮质激素和免疫抑制剂等。　结论　对于不明原因的肝损害患者应做免疫学筛查。

Citation： 王娟,唐红. 自身免疫性肝炎/原发性胆汁性肝硬化重叠综合征误诊为药物性肝炎一例. West China Medical Journal, 2010, 25(11): 2062-2063. doi: Copy

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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, 范上达, 廖光杰. 临床肝脏病学[M]. 上海: 上海科学技术出版社, 2004: 437-454, 483-497.
3. 　贾继东. 自身免疫性肝病的基本概念和诊断思路[J]. 中华肝脏病杂志, 2005, 13(1): 54.
4. 　温小凤, 蒋忠胜. AIH-PBC重叠综合征的诊断及治疗[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.

West China Medical Journal

自身免疫性肝炎/原发性胆汁性肝硬化重叠综合征误诊为药物性肝炎一例

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