自身免疫性肝病重叠综合征的临床治疗探讨

目的探讨自身免疫性肝病重叠综合征的治疗方法,提高治疗的有效性与安全性。方法 32例自身免疫性肝炎（AIH）-原发性胆汁性肝硬化（PBC）重叠综合征患者,均给予强的松（0.5mg.kg-1.d-1）联合熊去氧胆酸（UDCA,15 mg.kg-1.d-1）治疗,回顾性分析治疗前、后不同时段患者疾病状态的变化,评价临床疗效。结果所有患者症状、体征明显减轻,生化指标、肝脏病理损害均明显改善,与入院前比较差异有统计学意义（P〈0.01或P〈0.05）。IgG、IgM、抗平滑肌抗体（SMA）、抗线粒体抗体（AMA）治疗前后无明显变化,差异无统计学意义（P〉0.05）。结论强的松联合UDCA短期内能明显减轻AIH-PBC患者的临床症状、体征,改善生化学和肝组织学指标,提高患者生存质量,治疗安全有效。

Study on the treatment of overlap syndrome of autoimmune liver disease

Objective To investigate treatment of the overlap syndrome of autoimmune liver disease and to improve the efficacy and safety of the treatment.Methods We retrospectively analyzed the clinical data of 32 cases with autoimmune hepatitis（AIH） and primary biliary cirrhosis（PBC） overlap syndrome The patients were given prednisone（0.5 mg·kg-1·d-1） combined with UDCA（ursodeoxycholic acid）（15mg·kg-1·d-1）.Results The total situation of all patients improved significantly compared with pretreatment（P0.01 or P0.05）.The IgG,IgM,SMA,AMA level show no difference after treatment（P0.05）.Conclusion prednisone combined UDCA treatment can significantly reduce AIH-PBC symptoms and signs of patients and improve liver biochemistry and liver histological index.The treatment is safe and effective.