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| 1 | Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment显示文摘Non-classical manifestations of autoimmune hepatitis can delay diagnosis and treatment.Our aims were to describe the clinical phenotypes that can confound the diagnosis,detail scoring systems that can ensure their recognition,and outline advances in treatment that can improve their outcome.Prime source and review articles in English were selected through Medline from 1970-2008 and assimilated into personal libraries spanning 32 years.Acute severe or asymptomatic presentations and atypical histological findings,including centrilobular zone 3 necrosis and concurrent bile duct changes,are compatible with the diagnosis.Cholangiographic abnormalities may be present in children and adults with the disease,and autoimmune hepatitis must be considered in patients without autoantibodies or with antimitochondrial antibodies and no other cholestatic features.Asymptomatic patients frequently become symptomatic;mild disease can progress;and there are no conf ident indices that justify withholding treatment.Two diagnostic scoring systems with complementary virtues have been developed to evaluate patients with confusing features.Normal liver tests and tissue constitute the optimal end point of treatment,and the f irst relapse is an indication for long-term azathioprine therapy.Cyclosporine,tacrolimus and mycophenolate mofetil are promising salvage therapies,and budesonide with azathioprine may be a superior frontline treatment.We conclude that the non-classical phenotypes of autoimmune hepatitis can be recognized promptly,diagnosed accurately,and treated effectively. | Albert J Czaja Yusuf Bayraktar | 2009 | World Journal of Gastroenterology2009，15，19： | 4 |
| 2 | 酒精性肝病79例临床特征分析显示文摘目的分析酒精性肝病患者的临床特征。方法按照酒精性肝病诊断标准,将2009年1月~2015年1月期间我院消化科收治的酒精性肝病患者79例纳入回顾性病例对照研究,其中肝硬化患者56例,非肝硬化患者23例。住院期间戒酒者44例,结果出现酒精戒断综合征(AWS)者20例,无AWS者24例。结果酒精性肝硬化组年龄为(54.3±7.1)岁,总饮酒量为(5607.3±3667.0)g/年,均显著大于或多于非肝硬化组[(45.1±10.1)岁,(3884.5±2509.4)g/年,P<0.05];AWS组每日饮酒量为(222.1±121.5)g,总饮酒量为(5520.4±4400.1)g/年,均显著大于非AWS组[(139.5±92.2)g)和(4274.3±3136.8)g/年,P<0.05]。结论饮酒时间长和饮酒量大是导致酒精性肝硬化的主要原因,而这些患者不适当的戒酒可能会导致酒精戒断综合征,应注意预防和给予及时的处理。 | 郭宝娜 展玉涛 | 2018 | 实用肝脏病杂志2018，21，6： | 3 |
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