Analysis of clinical features of patients with autoimmune hepatitis/primary biliary cirrhosis overlap syndrome / 吉林大学学报(医学版)

ABSTRACT

Objective To compare the biochemical and immunological parameters and histopathological characteristics in the patients with autoimmune hepatitis (AIH),biliary cirrhosis (PBC)and AIH/PBC overlap syndrome,and to provide basis for working out the reference standard of clinical diagnosis and reasonable treatment.Methods 135 cases of autoimmune liver disease patients were selected,including 49 cases of AIH patients,43 cases of PBC patients, and 43 cases of AIH/PBC overlap syndrome patients. The biochemical, immunological parameters and histopathological changes of the patients were detected. The patients with AIH/PBC overlap syndrome were treated with different therapy methods including ursodesoxycholic acid (UDCA ) treatment,prednisone treatment and combination treatment with UDCA and prednisone,and the effectiveness of different treatment programs were evaluated.Results The activities of GGT and ALP and IgM level of the patients in the AIH/PBC group were significantly higher than those in AIH group,there were significant differences (P<0.05);the activities of ALT and AST and IgG level of the patients in AIH/PBC group was significantly higher than those in PBC group,there were significant differences (P<0.05).The detection rates of AMA and AMA M2 of the patients in AIH/PBC group were higher than those in AIH group, there were significant differences (P<0.05);the detection rates of ANA and SMA of the patients in AIH/PBC group were higher than those in PBC group,there were significant differences (P<0.05).There were high incidence of piecemeal necrosis (100.0%), liver cell rosette-like changes (83.72%)and bile duct lesions (69.77%)of the patients in AIH/PBC group.The effective percentage in combination therapy group was 85.7% which was significantly higher than those in various drug alone groups (P< 0.05 ). Conclusion The changes of biochemical and immunological indicators and pathological features of the patients with AIH/PBC overlap syndrome are in combination with the particular indicators of AIH and PBC which would provide the diagnostic basis for AIH/PBC overlap syndrome. The combined therapy for AIH/PBC overlap syndrome is effective and should be popularized.