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Analyses of the Clinical Features and the Influencing Factors of the Curative Effect of the120Cases with Type1Autoimmune Hepatitis

Author: WangJiaLi
Tutor: YaoYunQing
School: Chongqing Medical University
Course: Internal Medicine
Keywords: AIH-1 Clinical feature Influencing factors Curativeeffect
CLC: R575.1
Type: Master's thesis
Year: 2012
Downloads: 32
Quote: 0
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Abstract


Objective: To analyze the clinical features and the influencing factorsof the curative effect of the120cases with type1autoimmunehepatitis(AIH-1), expectantly to provide diagnosis and standard therapies forthe AIH-1.Method: Do the retrospective analysis of the clinical symptom,physical symptom, biochemistry, immunoglobulin, autoantibody,histopathology, treatment and the curative effect of the patients sufferedfrom type1autoimmune hepatitis which diagnosed from January2001toMarch2011in the First Affiliated Hospital of Chongqing MedicalUniversity. We divided AIH into remission group and failure group aftertreatment two to three weeks in the hospital. The remission group weresymptoms disappearance, normal serum bilirubin, γ-globulin levels andserum aminotransferases, normal hepatic tissue or inactive cirrhosis. Thefailure group were worsening the biochemistry, clinical symptoms andhistological and development of the ascites, jaundice and hepaticencephalopathy despite of treatment it. The two groups were compared using t-test(biochemistry and immunoglobulin), χ2-test(clinical symptomand treatment), enumeration data countable probability(autoantibody andother antibody). Make the outcomes to be dependent variable and the clinicalsymptom, physical symptom, biochemistry, immunoglobulin factors to beindependent variables.Use the logistic model to do multifactor regressionanalysis(P<0.05was entered, P>0.05was removed).The analyses wereperformed with the SPSS17.0software.Results: The most common symptoms were fatigue, jaundice andsplenomegaly in the AIH-1group.Serum albumin(ALB)levels werereduced.But the total bilirubin(TBIL),direct bilirubin(DBIL),alanineaminotransferase(ALT),aspartate aminotransferase(AST),serum alkalinephosphatase (ALP) and gamma-glutamyl transpeptidase(GGT) levels wereraised. IgG levels were significantly higher in the AIH-1group. All of theconventional serologic markers of antinuclear antibody were positive in theAIH-1group and AIH-1was predominanted by anti-multiple nuclear dotsand cytoplasm antibodies. The other autoantibodes may be useful in AIH-1which lack the conventional autoantibody markers of the antinuclearantibody. The interface hepatitis and the infiltrated by inflammatorycorpuscles were very common in the AIH-1, But the damage of the bile ductswere very rare. ALB, ALT and AST levels were significantly lower in failuregroup compared with remission group(P <0.05),but TBIL and DBILlevels were significantly higher than remission group(P<0.01).The univariate analysis revealed a significant correlation of seven variables toprognosis(P<0.05):clinicalsymptom(P<0.05),ALB(P<0.01),TBIL(P<0.01),DBIL(P<0.01),ALT(P<0.05),AST(P<0.05),autoantibody(P<0.05),But theage,sex, ALP,GGT, immunoglobulin, treatment have no correlation to theprognosis(P>0.05).Multivariate analysis of the above factors displayed ALB,TBIL, AST, immunoglobulin G(IgG) and the clinical symptom havingsomething to do with the prognosis of AIH-1.Conclusion: The clinical features had significant importance to thediagnosis of type1autoimmune hepatitis. ALB, TBIL, AST, IgG and theclinical symptom might be difference in AIH-1which needed to attach greatimportance. Early diagnosis and identification of the nonresponders wasvery important, especially in the severe disease, since timely and correcttherapy might prevent the illness to grew worse (liver failure) and avoidtransplanting.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Liver and gall bladder disease > Hepatitis
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