系统性硬化症中自身免疫性肝炎的患病率,临床特征和实验室预测因素:一个回顾性单中心队列研究
Zeynel Abidin Akar1, Dilan Yildirim2
1Division of Rheumatology, Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Dicle University, Kıtılbıl Neighborhood, Sur, Diyarbakır, Türkiye. zeynelabidin_akar@yahoo.com.
Clinical rheumatology
|March 6, 2026
概括
自身免疫性肝炎 (AIH) 是系统性硬化症 (SSc) 的罕见重叠,在7.2%的患者中发现. 氨酸氨基转移酶 (ALT) 水平>34.5U/L是进一步AIH评估的可靠指标.
科学领域:
- 类风湿病学 类风湿病学
- 肝病学 肝病学是一种肝病学.
- 临床免疫学临床免疫学
背景情况:
- 自身免疫性肝炎 (AIH) 是系统性硬化症 (SSc) 中罕见但显著的肝脏并发症.
- 在SSc患者中识别AIH对于及时有效治疗至关重要.
研究的目的:
- 为了确定在SSc患者中AIH的患病率.
- 描述AIH-SSc重叠的临床特征.
- 评估实验室标记物对SSc.AIH的诊断效用.
主要方法:
- 对111名SSc患者的回顾性分析.
- 在AIH阳性和AIH阴性组之间比较临床数据和自身抗体概况.
- 使用ROC曲线分析对ALT,AST和IgG的诊断性能评估.
主要成果:
- 在7.2%的SSc患者中发现了AIH,所有患者在活检上都显示了接口肝炎.
- AIH的患病率独立于SSc亚型,自身抗体或间歇性肺病.
- 氨酸氨基转移酶 (ALT) 显示了最高的诊断性能 (AUC 0.88),灵敏度为87.5%,特异性为85.4%,>34.5U/L.
结论:
- AIH是SSc中罕见但重要的重叠综合征,独立于临床表型而发生.
- 常规监测ALT是一种有价值的非侵入性查工具,用于SSc中的AIH.
- >34.5U/L的ALT值需要进一步的AIH调查,即使之前接触过甲状腺素.
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