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目的:探讨自身免疫性肝炎(AIH)与慢性乙型病毒性肝炎重叠综合征的临床及诊断。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,从确诊的50例AIH患者中筛选出14例AIH/乙肝重叠综合征患者,分析比较AIH/乙肝重叠综合征和单纯AIH患者的生化和免疫学指标。结果:50例AIH患者中,AIH/乙肝重叠综合征14例,单纯AIH 36例,分别占28%、单纯AIH 72%。AIH/乙肝重叠综合征患者ALT、AST、γ-球蛋白、ALT/ALP、SMA、ANA效价明显高于单纯AIH患者;AIH/乙肝重叠综合症患者兼有AIH和乙肝的双重组织学特点。结论:单纯AIH与AIH/乙肝重叠综合征患者的生化检查、免疫学及肝组织病理学特征上有差异,提示临床治疗药物的选择应区别对待。
Objective: To investigate the clinical and diagnosis of autoimmune hepatitis (AIH) and chronic hepatitis B overlap syndrome. Methods: A total of 14 patients with AIH / HBV overlap syndrome were screened from 50 diagnosed AIH patients by the newly revised descriptive diagnostic criteria and scoring system of the international autoimmune hepatitis group. The prevalences of AIH / HBV overlap syndrome and Biochemical and immunological indicators of patients with pure AIH. Results: Of the 50 patients with AIH, 14 were AIH / HBV overlap syndromes and 36 were AIH alone, accounting for 28% and 72%, respectively. ALT, AST, γ-globin, ALT / ALP, SMA and ANA were significantly higher in patients with AIH / hepatitis B overlap syndrome than those with AIH alone. Patients with AIH / HBV overlap had both histological features of AIH and HBV. Conclusion: The biochemical tests, immunology and histopathological features of AIH and AIH / HBV overlap syndrome are different, suggesting that the choice of clinical treatment should be treated differently.