Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
J Korean Med Sci. 2010 Jan;25(1):54-60. doi: 10.3346/jkms.2010.25.1.54. Epub 2009 Dec 29.
Immunosuppressive therapy can improve clinical, biochemical and histological features and considerably prolong survival in patients with autoimmune hepatitis. Although ethnicity may affect disease severity and presentation, the long-term outcome of immunosuppression in Korean populations is unknown. This study was aimed to assess the efficacy of immunosuppressive therapy and determine the prognosis of autoimmune hepatitis in Korean populations. We reviewed the medical records of 86 patients diagnosed as having autoimmune hepatitis at the Samsung Medical Center between 1994 and 2008. Seventy-two (83.7%) patients reached remission after a median treatment duration of 3.5 months (range 1 to 44 months). Attempts to withdraw medications were made in 24 cases after the median treatment duration of 36 months (median 6 to 125 months). Thirteen of 24 (54.1%) patients relapsed after treatment withdrawal. Of the 86 patients, 6 (7.2%) experienced disease progression and the overall 5-and 10-yr progression-free survival rates were 91.2% and 85.5%, respectively. In conclusion, immunosuppressive therapy for autoimmune hepatitis results in a favorable rate of remission and excellent progression-free survival, but the relapse rate after treatment withdrawal is high. This suggests that long-term immunosuppressive therapy may be particularly important for treatment of Korean patients.
免疫抑制疗法可以改善自身免疫性肝炎患者的临床、生化和组织学特征,并显著延长其生存时间。尽管种族可能会影响疾病的严重程度和表现,但韩国人群接受免疫抑制治疗的长期预后尚不清楚。本研究旨在评估免疫抑制疗法的疗效,并确定韩国人群自身免疫性肝炎的预后。我们回顾了 1994 年至 2008 年期间在三星医疗中心诊断为自身免疫性肝炎的 86 例患者的病历。72 例(83.7%)患者在中位治疗 3.5 个月(1 至 44 个月)后达到缓解。在中位治疗 36 个月(6 至 125 个月)后,尝试在 24 例中停用药物。24 例中有 13 例(54.1%)在停药后复发。在 86 例患者中,有 6 例(7.2%)出现疾病进展,总的 5 年和 10 年无进展生存率分别为 91.2%和 85.5%。总之,自身免疫性肝炎的免疫抑制治疗可达到较高的缓解率和良好的无进展生存率,但停药后的复发率较高。这表明长期免疫抑制治疗对韩国患者的治疗可能尤为重要。