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首页> 外文期刊>European journal of gastroenterology and hepatology >Frequency and predictive factors for overlap syndrome between autoimmune hepatitis and primary cholestatic liver disease.
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Frequency and predictive factors for overlap syndrome between autoimmune hepatitis and primary cholestatic liver disease.

机译：自身免疫性肝炎和原发性胆汁淤积性肝病之间重叠综合征的发生频率和预测因素。

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OBJECTIVES: To evaluate the frequency of cholestatic pattern in patients with autoimmune hepatitis (AIH) and to identify predictive factors associated with the development of the overlap syndrome. METHODS: Eighty-two consecutive patients diagnosed with AIH at the referral centre between January 1998 and June 2002 were included in the study. The new scoring system modified by the International Autoimmune Hepatitis Group was used to classify patients as definite/probable. Overlap syndrome was considered when the patient had clinical, serological and histological characteristics of two conditions: AIH and primary biliary cirrhosis (PBC) or AIH and primary sclerosing cholangitis (PSC). RESULTS: From the 82 AIH patients (76 female and six male), 84.1% presented definite AIH (> 15 points) and 15.9% probable AIH (10-15 points). The frequency of the overlap syndrome was 20%: 13% with PBC and 7% with PSC. In the univariate analysis the overlap syndrome was associated with male gender (P = 0.01), age < 35 years (P < 0.0001), histopathological aspect of cholestasis (P < 0.0001), suboptimal response to treatment (P < 0.0001) and probable AIH (P < 0.0001). Age < 35 years, probable AIH and the absence of anti-nuclear antibody (ANA) have been identified as independent indicators of the overlap diagnosis by the logistic regression analysis. CONCLUSION: Patients with overlap syndrome between AIH and primary cholestatic liver disease are frequently diagnosed in clinical practice, representing 20% of AIH cases in our study. The independent predictive factors associated with the diagnosis of overlap syndrome are young age, ANA(-) profile, and probable diagnosis according with the scoring system for AIH.
机译：目的：评估自身免疫性肝炎（AIH）患者的胆汁淤积模式的频率，并确定与重叠综合征发展相关的预测因素。方法：本研究纳入了1998年1月至2002年6月在转诊中心被诊断为AIH的82例连续患者。由国际自身免疫性肝炎小组修改的新评分系统用于将患者分类为确定/可能。当患者具有以下两种情况的临床，血清学和组织学特征时，即认为是重叠综合征：AIH和原发性胆汁性肝硬化（PBC）或AIH和原发性硬化性胆管炎（PSC）。结果：在82例AIH患者中（女性76例，男性6例），有84.1％的患者表现为明确的AIH（> 15分），有15.9％的患者表现为AIH（10-15分）。重叠综合征的发生率为20％：PBC为13％，PSC为7％。在单变量分析中，重叠综合征与男性（P = 0.01），年龄<35岁（P <0.0001），胆汁淤积的组织病理学特征（P <0.0001），对治疗的最佳反应（P <0.0001）和可能的AIH相关（P <0.0001）。年龄<35岁，可能的AIH和不存在抗核抗体（ANA）已通过逻辑回归分析确定为重叠诊断的独立指标。结论：在临床实践中经常诊断出AIH与原发性胆汁淤积性肝病之间有重叠综合征的患者，在本研究中占AIH病例的20％。与重叠综合征诊断相关的独立预测因素是年龄，ANA（-）资料以及根据AIH评分系统进行的可能诊断。

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