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转氨酶升高的特发性炎性肌病患者肝脏损伤的研究

贺玉凯 闪海霞 张帆 吴爱华 朱幼芙

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转氨酶升高的特发性炎性肌病患者肝脏损伤的研究

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  • 中图分类号: R746.5;R593.26

  • 摘要: 目的探讨转氨酶升高的特发性炎性肌病(Idiopathic Inflammatory Myopathy,IIM)患者肝脏损伤情况及血清ALT来源;观察IIM患者与自身免疫性肝炎(autoimmune hepatitis,AIH)患者肝组织中CD138+浆细胞浸润情况。方法分析28例IIM患者临床及血清学资料,并对其中6例IIM患者及另外11例AIH患者行肝活检(HE常规染色和免疫组化特异性染色)。结果IIM患者血清ALT均值(198.8±209.0)U/L,50%(14/28)的患者血清ALT轻度升高,在(40120)U/L之间,与AIH患者无明显差异(P>0.05),与健康人有显著性差异(P<0.01);乳酸脱氢酶(LDH)和羟丁酸脱氢酶(HBDH)异常率为100%和85.7%,显著高于肌酸激酶(CK)的78.6%;组织学检查:IIM患者肝组织损伤轻微,肝窦内和汇管区有少至中量炎症细胞浸润,未发现明显CD138+浆细胞浸润;而AIH患者肝组织损伤较重,汇管区有大量炎症细胞浸润并向周围肝实质扩散,汇管区有明显CD138+浆细胞浸润。结论转氨酶升高的IIM...

     

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