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題 名 | Prevalence of Autoantibodies in Uremic Patients with HCV Infection=臺灣接受血液透析之C型肝炎患者血清中自體免疫抗體之表現 |
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作 者 | 陳鴻運; 趙有誠; 嚴助成; 徐榮源; 陳永煌; | 書刊名 | 醫學研究 |
卷 期 | 20:1 1999.08[民88.08] |
頁 次 | 頁7-12 |
分類號 | 414.82 |
關鍵詞 | 自體免疫抗體; 類風濕性因子; 自體抗核抗體; 抗平滑肌抗體; 自體免疫性肝炎; Arti-nuclear antibodies; ANAs; Anti-smooth muscle antibodies; SMAs; Autoantibodies; Autoimmune hepatitis; AIH; Rheumatoid factor; RF; |
語 文 | 英文(English) |
中文摘要 | C型肝炎的治療與自體免疫性肝炎截然不同。前者我們選擇干擾素治療,後者我們使用類固醇治療。因此臨床上對這兩種肝病的鑑別診斷非常重要。西方國家過去有研究發現,慢性C型肝炎病人血中自體免疫抗體標記呈陽性的比例較常人為高,不過至今對此現象仍未有合理之解釋。本研究針對接受血液透析之C型肝炎病人,一般C型肝炎病人及慢性B型肝炎病人,血清中自體免疫抗體標記之陽性率做一比較,以瞭解臺灣地區C型肝炎病人血清中自體免疫抗體標記之陽性情況。結果發現國人罹患C型肝炎患者,其血中類風濕性因子及自體抗核抗體陽性的比例,雖較慢性B型肝炎病人為高,但不具統計學之差異;不過此兩組病患血中類風濕性因子及自體抗核抗體陽性率確較對照組呈統計學上有明顯意義之偏高(P<0.05)。而接受血液透析之C型肝炎患者,其血中自體免疫抗體出現情況,與一般C型肝炎患者無異。接受血液透析之C型肝炎患者,與一般C型肝炎患者及B型肝炎病患,其血中抗平滑肌抗體陽性率均在五成之以上,但與對照組無統計學上差異,此與國外報告結果相似。國人罹患C型肝炎患者,其血中自體免疫抗體之陽性表現與年齡和性別無關。本結果顯示,國人罹患C型或B型肝炎患者,其血中自體免疫抗體陽性情況確較常人為高,其所呈現之意義仍待進一步探討。 |
英文摘要 | The advent of specific antiviral therapy for chronic hepatitis C has increased the importance of establishing the correct etiology of chronic hepatitis in patients, especially because interferon alfa(IFN-£) has been reported to exacerbate autoimmune hepatitis(AIH), whereas corticosteroids increase viral replication in chronic hepatitis C. In evaluating patients with chronic hepatitis, we have observed apparent chronic hepatitis C who had serologic and clinical evidence of autoimmunity. The aim of this study is to determine the pattern and prevalence of autoantibodies in uremic patients with HCV infection and others with different liver disease. We studied 162 consecutive, unselected adult patients at our center, identified between September 1997 and December 1997, as having hepatitis C antibodies by second-generation EIA. To be included in the group with chronic hepatitis C, patients were required to have (1) chronic elevation of serum transaminases for at least six months; (2) negative hepatitis B surface antigen; (3) no evidence for other causes of chronic hepatitis. Anti-nuclear antibodies(ANA), anti-smooth muscle antibodies(ASMA) and rheumatoid factor(RF) were performed using the procedure as mentioned by Cliford et al. The results were as follows, anti-smooth muscle autoantibodies were common in our chronic hepatitis patients, but no significant difference had appeared against normal control group. Anti-nuclear antibodies and rheumatoik factor were more frequent in chronic hepatitis C patients than in chronic hepatitis B patients, but there was no significant difference. The prevalence of positive RF and ANA in uremic HCV and chronic HCV patients were not significantly different. The prevalence of autoimmune markers between the elderly group and younger group was not different, either. In conclusion, we report a high prevalence of RF and ANA in chronic HCV patients compared with normal population. The prevalence of serological autoantibodies in the HCV patients and the uremic HCV patients were of no significant difference. |
本系統中英文摘要資訊取自各篇刊載內容。