Soares Júlia C, Borgonovo Ariane, Maggi Dariana C, Pasinato Ana P B F, Ramos Fernanda G, Dantas-Corrêa Esther B, Schiavon Leonardo L, Narciso-Schiavon Janaína L
Division of Gastroenterology, Internal Medicine, Federal University of Santa Catarina, Florianópolis, Brazil -
Minerva Gastroenterol Dietol. 2016 Jun;62(2):138-47.
Autoimmune hepatitis (AIH) is a disease that presents itself in various forms, ranging from aminotransferase asymptomatic alteration, acute hepatitis to decompensated cirrhosis. Few studies have evaluated the predictive criteria as a response to treatment.
A cross-sectional analytical study examined patients with AIH who were visited in the hepatology clinic of a university hospital between January 2013 and July 2015.
A total of 36 patients were included (44.7 ± 14.3 years, 22.2% male, and 19.2% of patients presented with liver failure). Patients with significant fibrosis had lower mean aminotransferases and bilirubins and higher mean prothrombin activity (PA) than those with insignificant fibrosis. Most patients (94.5%) underwent treatment with azathioprine and prednisone. In a comparison between individuals who exhibited biochemical response (ALT and AST < 55 U/L in the sixth month of treatment) and those without biochemical response, it was observed that those with biochemical response presented minor proportion of patients with significant fibrosis, and these patients had a higher proportion of liver failure in initial presentation and lower mean PA. Furthermore, it was observed that the lower the PT on admission was, the lower ALT levels (r = 0.682, P = 0.020) and AST (r = 0.431, P = 0.040) in the sixth month of treatment were.
Individuals with liver dysfunction and elevated aminotransferases show insignificant fibrosis histologically. AIH patients who initially present liver failure and insignificant fibrosis are more likely to develop biochemical response to treatment.
自身免疫性肝炎（AIH）是一种表现形式多样的疾病，从无症状的转氨酶改变、急性肝炎到失代偿性肝硬化。很少有研究评估作为治疗反应的预测标准。
一项横断面分析研究对2013年1月至2015年7月期间在一家大学医院肝病门诊就诊的AIH患者进行了检查。
共纳入36例患者（年龄44.7±14.3岁，男性占22.2%，19.2%的患者出现肝衰竭）。与纤维化不明显的患者相比，纤维化明显的患者平均转氨酶和胆红素水平较低，凝血酶原活动度（PA）平均水平较高。大多数患者（94.5%）接受了硫唑嘌呤和泼尼松治疗。在对表现出生化反应（治疗第六个月时ALT和AST<55 U/L）的个体与未表现出生化反应的个体进行比较时，发现表现出生化反应的个体中纤维化明显的患者比例较小，但这些患者在初始表现时肝衰竭比例较高，PA平均水平较低。此外，还观察到入院时PT越低，治疗第六个月时ALT水平（r = 0.682，P = 0.020）和AST水平（r = 0.431，P = 0.040）越低。
肝功能不全和转氨酶升高的个体组织学上纤维化不明显。最初表现为肝衰竭且纤维化不明显的AIH患者更有可能对治疗产生生化反应。
