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Clinical Study of the Diagnostic Scoring System of Autoimmune Hepatitis
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摘要: 研究自身免疫性肝炎临床诊断与应用国际自身免疫性肝炎小组 （IAIHG）制订的评分诊断标准所作的评分诊断的一致性 ,评估此评分诊断标准在临床应用上的可行性。回顾性研究 1999- 2 0 0 1住院患者 14 12例 ,筛选其中自身抗体阳性、病毒指标阴性的 4 6例患者为对象 ,其中自身免疫性肝炎 （AIH） 18例 ,原发性胆汁性肝硬化 （PBC）2 1例 ,原发性干燥综合征 （PSS） 7例。根据 1999年IAIHG制定的评分诊断标准予以打分。 18例临床诊断为AIH的患者 ,得分在 10～ 15的 12例 ,符合可能的AIH ;大于 15的 4例 ,符合确定的AIH ;小于 10的 2例 ,不能诊断为AIH。2 1例临床诊断为PBC的患者 ,得分均小于 10。 7例临床诊断为PSS的患者 ,5例得分在 10～ 15 ,符合可能的AIH诊断 ;2例小于 10 ,不符合AIH的诊断。AIH临床诊断与评分诊断一致性较高 （16 / 18） ,而PBC无一例符合 ,反应此标准特异性、准确性高 ,适合临床应用Abstract: To study the uniformity between the clinical diagnosis and the diagnosis using the scoring system revised by the International Autoimmune Hepatitis Group (IAIHG) of Autoimmune Hepatitis (AIH) , and assess the feasibility of the scoring system in clinical use. 46 patients with negative viral markers and positive autoantibodies were singled out from 1412 patients seen in our hospital from 1999 to 2001. Of the 46 patients, 18 patients were clinically diagnosed as AIH, 21 patients were primary Biliary Cirrhosis (PBC) , 7 patients were Primary Sjgren Syndrome (PSS) . All data were analyzed by using the revised scoring system proposed by IAIHG in 1998. Within 18 patients clinically diagnosed as AIH, 12 patients' score were 10-15 and met the criteria of probable AIH; 4 patient's score were above 15 and met the definite AIH; 2 patients' score were below 10 and categorized as others. None of the 21 patients diagnosed as Primary Biliary Cirrhosis (PBC) had a score above 10. Within 7 patients diagnosed as Primary Sjgren Syndrome (PSS) , 5 patients' score were 10-15 and 2 patients' were below 10. The revised scoring system of AIH showed high accuracy in diagnosing clinical AIH and could effectively exclude patients with biliary diseases. The scoring system is suitable for clinical use.
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