| 冯舒婷,朱肖鸿,余选良.不明原因肝功能异常患者的病理结果及临床资料分析[J].浙江中西医结合杂志,2017,27(11): |
| 不明原因肝功能异常患者的病理结果及临床资料分析 |
| Pathological results and clinical data of patients with unexplained abnormal liver function |
| 投稿时间：2017-02-16 修订日期：2017-04-03 |
| DOI： |
| 中文关键词: 不明原因 肝功能不全 病理特点 临床表现 |
| 英文关键词:Unexplained Abnormal liver function Pathological characteristics Clinical manifestations |
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| 中文摘要: |
| 目的 通过对33例经肝组织活体检查术(简称“肝活检”)诊断明确的不明原因肝功能异常患者的病理及临床资料分析,总结导致肝功能异常的病因以及不同病因的临床及病理特点,为今后肝脏损害患者的临床诊断提供思路,减少误诊与漏诊。方法 回顾性分析浙江中医药大学附属第一医院感染科2014年12月至2016年6月以来在B超定位下行1秒肝穿刺的不明原因肝功能异常患者的病理诊断。结果 1.33例不明原因肝功能异常患者通过一般的临床资料及实验室检查分析,均难以得出诊断,通过肝活检大多数可明确诊断,包括自身免疫性肝炎(autoimmune hepatitis,AIH)12例(36.4％)、原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)1例(3%)、药物性肝损伤(drug - induced liver injury,DILI)7例(21.2％)、非酒精性脂肪性肝病(NAFLD)4例(12.1％)、非特异性炎症6例(18.2％)、肝内胆汁淤积1例(3%)、轻度脂肪变性2例(6.1%)。结论 1.肝活检是不明原因肝功能异常患者明确诊断的重要方法；2.自身免疫性肝病和药物性肝损伤是不明原因肝功能异常最主要的原因；3.临床资料特点,自身免疫性肝病(包括自身免疫性肝炎、原发性胆汁性肝硬化)男女比例为1:12,年龄集中分布在(45-60)岁。 |
| 英文摘要: |
| Purpose The pathology and clinical data of 33 patients with unexplained abnormal liver function diagnosed by liver biopsy were reviewed. Summarizing the etiology of liver dysfunction and the clinical and pathological characteristics of different causes, which provide ideas for the clinical diagnosis of patients with liver damage in the future, to reduce the misdiagnosis and missed diagnosis. Methods We retrospectively analyzed the pathologic diagnosis of patients with unexplained liver dysfunction who underwent liver biopsy for one second from December 2014 to June 2016 in Department of Infectious Diseases, First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine. Results 1.33 cases of unexplained liver dysfunction in patients were difficult to get diagnosed through general clinical data and laboratory analysis,but were diagnosed by liver biopsy .Including 12 cases of autoimmune hepatitis (36.4%), 1 case of primary biliary cirrhosis (3%), 7 cases of drug-induced liver injury (21.2%), 4 cases of non alcoholic fat liver disease (12.1%), 6 cases of nonspecific inflammation (18.2%), 1 case of intrahepatic cholestasis (3%), 2 cases of mild steatosis (6.1%). Conclusion 1.Liver biopsy is an important method to diagnose patients of unexplained abnormal liver function;2. Autoimmune liver disease and drug-induced liver injury are the most important reason for unexplained abnormal liver function;3. Clinical data characteristics, autoimmune liver disease (including autoimmune hepatitis,primary biliary cirrhosis) the ratio of male to female is 1:12, aged distribution in 45 years old -60 years old. |
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