论文部分内容阅读
目的 研究原发性干燥综合征 (pSS)合并肝脏损害的临床特点 ,探讨其病理本质。方法 分析 5 6例 pSS病例中合并肝脏损害及不伴肝脏损害的临床资料。 结果 5 6例 pSS病例中 13例合并肝脏损害 ,发生率为 2 3 2 % ,其性别、年龄、从发病到确诊时间以及ANA、抗SSA、抗SSB、类风湿因子、IgG、γ 球蛋白阳性率方面与不伴肝脏损害之间的差异均无显著性 (P >0 0 5 )。 13例中 6例AKP、γ GT同时升高 ,4例AKP、γ GT、TBIL、DBIL同时升高。查抗平滑肌抗体 (抗SMA)、抗线粒体抗体 (AMA)的 8例中 ,5例AMA阳性。 6例进行肝穿刺活组织检查 ,病理诊断为慢性活动性肝炎 3例 ,其中 2例合并肝硬化 ;慢性迁延性肝炎 1例 ,小胆管炎 2例。 6例中 5例均有不同程度的汇管区单个核细胞浸润。结论 pSS合并肝脏损害并不少见 ,可能与原发性胆汁性肝硬化相关。患者对激素治疗敏感 ,预后较好。
Objective To study the clinical features of primary sjogren’s syndrome (pSS) combined with liver damage and to explore its pathological nature. Methods Clinical data of 56 patients with pSS complicated with liver damage and without liver injury were analyzed. Results Thirteen of 56 cases of pSS complicated with liver damage, the incidence was 23.2%. The gender, age, onset time to diagnosis and ANA, anti-SSA, anti-SSB, rheumatoid factor, IgG, There was no significant difference between rate and without liver damage (P> 0.05). In 13 cases, 6 cases of AKP, γ GT increased at the same time, 4 cases of AKP, γ GT, TBIL, DBIL increased at the same time. Among 8 cases of anti-smooth muscle antibodies (anti-SMA) and anti-mitochondrial antibodies (AMA), 5 were positive for AMA. Liver biopsy was performed in 6 cases. The pathological diagnosis was chronic active hepatitis in 3 cases, of which 2 cases were complicated with cirrhosis, 1 case of chronic persistent hepatitis and 2 cases of small cholangitis. Five of the 6 cases had different degrees of portal mononuclear cell infiltration. Conclusion pSS complicated with liver damage is not uncommon, may be associated with primary biliary cirrhosis. Patients are sensitive to hormone therapy, the prognosis is good.