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[自身免疫性肝炎:当前认知]

[Autoimmune hepatitis: present knowledge].

作者信息

Durazzo M, Premoli A, Morello E

机构信息

Dipartimento di Medicina Interna, Università degli Studi di Torino, Torino, Italy.

出版信息

Minerva Med. 2004 Feb;95(1):1-9.

Abstract

Autoimmune hepatitis (AIH) is a rare and chronic disease which may lead to liver cirrhosis if not correctly treated. Its etiology is unknown, but some progresses have been obtained in the knowledge of damage pathogenesis, its immune mechanisms and genetic predisposition (female gender, presence of HLA DR3 and HLA DR4). It seems that such predisposition favours some agents (e.g. drugs or viruses) to trigger the pathological process. Patients present with variable, often few and unspecific symptoms. Diagnosis is made on the basis of anamnestic (absence of other causes, such as virus infections or alcohol abuse), serological (autoantibodies, high levels of aminotransferases, hypergammaglobulinemia), and histological data (piecemeal necrosis further to bridging necrosis, panlobular and multilobular necrosis); these data are processed by a scoring system which is helpful for the diagnostic definition. Therapy is founded in immunosuppressor drugs, mainly steroids and azathioprine, but a lot of other drugs have been studies for cases of recurrence and of intolerance to the standard treatment.

摘要

自身免疫性肝炎(AIH)是一种罕见的慢性疾病,若未得到正确治疗可能会导致肝硬化。其病因尚不清楚,但在损伤发病机制、免疫机制和遗传易感性(女性、存在HLA DR3和HLA DR4)方面已取得了一些进展。似乎这种易感性有利于某些因素(如药物或病毒)触发病理过程。患者表现出多样的症状,通常较少且不具特异性。诊断基于既往史(不存在其他病因,如病毒感染或酒精滥用)、血清学(自身抗体、高水平转氨酶、高球蛋白血症)和组织学数据(桥接坏死继发的碎片状坏死、全小叶和多小叶坏死);这些数据通过一个评分系统进行处理,该系统有助于诊断定义。治疗基于免疫抑制药物,主要是类固醇和硫唑嘌呤,但对于复发和对标准治疗不耐受的病例,已经研究了许多其他药物。

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