Minuk G Y, Liu S, Kaita K, Wong S, Renner E, Rempel J, Uhanova J
Department of Medicine, University of Manitoba, Winnipeg, Manitoba.
Can J Gastroenterol. 2008 Oct;22(10):829-34. doi: 10.1155/2008/642432.
North American Aboriginal populations are at increased risk for developing immune-mediated disorders, including autoimmune hepatitis. In the present study, the demographic, clinical, biochemical, serological, radiological and histological features of autoimmune hepatitis were compared in 33 First Nations (FN) and 150 predominantly Caucasian, non-FN patients referred to an urban tertiary care centre. FN patients were more often female (91% versus 71%; P=0.04), and more likely to have low serum albumin (69% versus 36%; P=0.0006) and elevated bilirubin (57% versus 35%; P=0.01) levels on presentation compared with non-FN patients. They also had lower hemoglobin, and complement levels, more cholestasis and higher serum immunoglobulin A levels than non-FN patients (P=0.05 respectively). Higher histological grades of inflammation and stages of fibrosis, and more clinical and radiological evidence of advanced liver disease were observed in FN patients, but the differences failed to reach statistical significance. The results of the present study suggest that in addition to being more common, autoimmune hepatitis may be more severe in FN populations, compared with predominantly Caucasian, non-FN populations.
北美原住民患免疫介导疾病（包括自身免疫性肝炎）的风险增加。在本研究中，对转诊至一家城市三级护理中心的33名原住民（FN）患者和150名主要为非原住民的白种人患者的自身免疫性肝炎的人口统计学、临床、生化、血清学、放射学和组织学特征进行了比较。与非FN患者相比，FN患者女性更为常见（91%对71%；P=0.04），就诊时血清白蛋白水平较低（69%对36%；P=0.0006）和胆红素水平升高（57%对35%；P=0.01）的可能性更大。与非FN患者相比，他们的血红蛋白和补体水平也更低，胆汁淤积更多，血清免疫球蛋白A水平更高（P均为0.05）。在FN患者中观察到更高的炎症组织学分级和纤维化阶段，以及更多晚期肝病的临床和放射学证据，但差异未达到统计学意义。本研究结果表明，与主要为非原住民的白种人人群相比，自身免疫性肝炎在FN人群中不仅更为常见，而且可能更为严重。
