Peng Milin, Li Yi, Zhang Min, Jiang Yongfang, Xu Yuan, Tian Yi, Peng Feng, Gong Guozhong
Center of Liver Diseases, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China.
Exp Ther Med. 2014 Jan;7(1):145-148. doi: 10.3892/etm.2013.1363. Epub 2013 Oct 25.
The Chinese population are at an increased risk of autoimmune hepatitis (AIH). The aims of this study were to determine the demographic and clinical features of AIH in China. A total of 83 patients with AIH diagnosed by the revised scoring system were re-analyzed, and the clinical presentations among the different ages were compared. The patients were classified according to age at presentation. AIH occurred in patients aged ≤30 years (9.6%), 31-39 years (10.8%), 40-49 years (16.9%), 50-59 years (31.3%) and ≥60 years (31.3%). There were no differences in the form of the clinical presentation, concurrent autoimmune diseases, cirrhosis distribution and autoantibodies among the groups. However, patients aged ≥60 years presented with higher levels of alkaline phosphatase (ALP) and γ-glutamyl transpeptidase (γ-GT) compared with patients aged ≤30 years (P=0.034, P=0.043, respectively), and patients aged 31-39 years had a significantly lower immunoglobulin G (IgG) level compared with those aged 50-59 years (P=0.049) and those aged ≥60 years (P=0.012). By contrast, patients aged ≤30 years had a significantly higher total bilirubin (TBIL) level compared with those aged 31-39 years (P=0.007), 50-59 years (P=0.002) and ≥60 years (P=0.013). A substantial portion of patients with AIH were aged >60 years, indicating a poor liver-associated outcome under current management strategies. Elderly patients appeared to be more asymptomatic compared with the younger patients.
中国人群患自身免疫性肝炎(AIH)的风险增加。本研究旨在确定中国AIH的人口统计学和临床特征。对83例经修订评分系统诊断为AIH的患者进行重新分析,并比较不同年龄组的临床表现。患者根据就诊时的年龄进行分类。AIH发生在年龄≤30岁的患者中占9.6%,31 - 39岁的患者中占10.8%,40 - 49岁的患者中占16.9%,50 - 59岁的患者中占31.3%,≥60岁的患者中占31.3%。各组之间在临床表现形式、并发自身免疫性疾病、肝硬化分布和自身抗体方面无差异。然而,与年龄≤30岁的患者相比,≥60岁的患者碱性磷酸酶(ALP)和γ-谷氨酰转肽酶(γ-GT)水平较高(分别为P = 0.034,P = 0.043),31 - 39岁的患者免疫球蛋白G(IgG)水平显著低于50 - 59岁的患者(P = 0.049)和≥60岁的患者(P = 0.012)。相比之下,年龄≤30岁的患者总胆红素(TBIL)水平显著高于31 - 39岁的患者(P = 0.007)、50 - 59岁的患者(P = 0.002)和≥60岁的患者(P = 0.013)。相当一部分AIH患者年龄>60岁,表明在当前管理策略下肝脏相关预后较差。与年轻患者相比,老年患者似乎更无症状。