郭建华 谷鸿彦

[摘要] 自身免疫性肝病是一种特殊类型的肝脏疾病，其发病与患者免疫机制异常有关，临床多出现黄疸、发热、关节炎等症状，实验室检测可发现自身抗体，亦可合并其他系统自身免疫性疾病。治疗主要采用激素、硫唑嘌呤等免疫抑制剂。目前，随着我国医疗水平的逐步提高，对该疾病的认识和水平也有了长足的进步，本文就该疾病近年来的诊疗情况作一综述，以期能更深入地研究其发病机制及临床诊疗。

[关键词] 自身免疫性肝病；发病机制；诊断；治疗

[中图分类号] R575[文献标识码]A [文章编号]1673-7210（2011）11（c）-013-02

The progress research of autoimmune liver disease

GUO Jianhua, GU Hongyan

The Hospital of Gaobeidian City, Hebei Province, Gaobeidian 074000, China

[Abstract] Autoimmune liver disease (AILD) which is related to abnormality of immune system is a special type of the liver disease. The clinical appearance of AILD includes jaundice, fever, arthritis, and so on. Autoantibodies can be found in the patients by laboratory tests. The patients of AILD may also suffer from other autoimmune diseases. Hormones, azathioprine and other immunosuppressive agents are the main therapeutic drugs taken by these patients. Along with the development of medical service in our country, the understanding of ALID has gained great progress. To explore the pathogenesis and treatment of ALID further, this article reviews on the diagnosis and treatment of ALID in recent years.

[Key words] Autoimmune liver disease; Pathogenesis; Diagnosis; Treatment

自身免疫性肝病是一种由自身抗体介导的肝胆系统免疫性疾病，根据其临床表现、影响学改变、组织病理学特点可分为3种类型，包括自身免疫性肝炎（autoimmune hepatitis，AIH）、原发性胆汁性肝硬化（primarybiliary cirrhosis，PBC）和原发性硬化性胆管炎（primarysclgrosing cholangitis，PSC）[1]。自身免疫性肝病目前尚无根治措施，病情进展可发生肝硬化甚至肝癌，严重威胁患者生命。近年来，随着检验技术的提高和对该疾病认识的深入，越来越多的国内学者开始重视对该疾病的研究[2]。现对该疾病发病机制、诊断、治疗研究进展作一综述，以期为改善该疾病的诊疗现状提供帮助。

1 发病机制

目前世界医学难题之一即自身免疫性疾病的发病机制，随着人们对免疫性疾病认识的逐渐加深，各个系统、领域的自身免疫性疾病发病机制的研究也如火如荼地展开，免疫性肝病的研究也不例外。从遗传易感性、抗原免疫激活、理化影响因素等各个方面均有不同程度的进展[3]。……