自身免疫性肝炎合并进展性肝纤维化患者的影响因素分析

肝脏 ›› 2026, Vol. 31 ›› Issue (7): 954-957.

自身免疫性肝炎合并进展性肝纤维化患者的影响因素分析

孙微, 余虹, 窦婧, 王转国, 宁忠慧, 王晓波, 帕力达·帕拉哈提, 王晓忠, 郭峰

712046 咸阳陕西中医药大学附属医院(孙微);
834099 克拉玛依新疆克拉玛依市中心医院感染科(余虹);
830054 乌鲁木齐新疆医科大学附属中医医院肝病科(窦婧,王转国,宁忠慧,王晓波,王晓忠,郭峰);
844000 喀什喀什地区第二人民医院(帕力达·帕拉哈提)

收稿日期:2025-08-06 出版日期:2026-07-31 发布日期:2026-08-21
通讯作者: 郭峰,Email: gf_sj@163.com
基金资助:
病因治疗对自身免疫性肝病再代偿中纤维化逆转的评估研究(2024TSYCJC0052)

An analysis on the predicting factors of progressive liver fibrosis (≥F3) in autoimmune hepatitis patients

Sun Wei¹, Yu Hong², Dou Jing³, Wang Zhuanguo³, Ning Zhonghui³, Wang Xiaobo³, Palida Palahati⁴, Wang Xiaozhong³, Guo Feng³

1. Department of Hepatology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, China;
2. Department of Infection, Xinjiang Karamay Central Hospital, Karamay 834099, China;
3. Department of Hepatology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urmqi 830054, China;
4. the Second People′s Hospital of Kashgar Prefecture, Kashgar 844000, China

Received:2025-08-06 Online:2026-07-31 Published:2026-08-21
Contact: Guo Feng,Email: gf_sj@163.com

摘要/Abstract

摘要： 目的探讨自身免疫性肝炎(AIH)合并进展性肝纤维化(≥F3)患者的临床影响因素,为早期风险分层及干预提供依据。方法回顾性分析2021年11月至2024年6月新疆医科大学附属中医医院肝病科收治的113例AIH住院患者的临床数据:人口学特征、血清学指标(ALT、AST、γ-GT、IgG)、肝功能参数(PLT、Alb)及无创纤维化评分(FIB-4、APRI、GPR)等;并根据肝活检组织病理学分期,将患者分为进展性纤维化组(≥F3,n=47)与非进展性纤维化组(<F3,n=66);多变量logistic回归分析评估独立影响因素。结果队列中女性占比87.0%(98/113),平均年龄51.8±10.0岁,进展性纤维化发生率为41.6%。进展性纤维化组PLT显著降低[143.00(98.00±196.00)×10⁹/L,P<0.05)]、Alb水平下降[33.57(29.10,38.60)g/L,P<0.05)],同时FIB-4[5.57(3.58,11.16),P<0.05]及APRI评分[3.77(1.90,7.65),P<0.05)]显著升高。多变量分析显示,PLT(OR=0.991,95% CI: 0.984~0.998,P=0.014)和Alb(OR=0.900,95% CI: 0.820~0.988,P=0.027)是进展性肝纤维化的独立影响因素,PLT减少及低白蛋白血症可能加速纤维化进程。结论 PLT和Alb水平可作为AIH患者肝纤维化进展的潜在生物标志物,其动态监测有助于早期识别高危人群并优化个体化治疗策略。

关键词: 自身免疫性肝炎, 进展性肝纤维化, 血小板计数, 白蛋白, 无创生物标志物

Abstract: Objective Identify the clinical predictors of advanced hepatic fibrosis (≥F3 stage) in patients with autoimmune hepatitis (AIH) through retrospective cohort analysis, and to provide evidence for early risk stratification and intervention. Methods The clinical data of 113 AIH inpatients admitted to the department of hepatology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University between November 2021 and June 2024 were retrospectively analyzed. Parameters including demographic characteristics, liver function indices of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (γ-GT), albumin (Alb), serological markers of Immunoglobulin G (IgG), blood platelet (PLT) and non-invasive fibrosis scores including Fibrosis 4 score (FIB-4), AST to platelet ratio index (APRI), GGT-to-platelet ratio (GPR). Based on histopathological staging, patients were categorized into an advanced fibrosis (≥F3, n=47) and a non-advanced fibrosis (<F3, n=66) groups. Multivariate logistic regression analysis was performed to identify the independent predictors of advanced hepatic fibrosis. Results Female patients comprised 87.0% (98/113) of the cohort, with a mean age of 51.8±10.0 years. The prevalence of advanced fibrosis was 41.6%. The advanced fibrosis group exhibited significantly lower platelet counts (PLT: 143.00 [98.00~196.00]×10⁹/L, P<0.05) and albumin levels (Alb: 33.57 [29.10~38.60]g/L, P<0.05), alongside elevated FIB-4 (5.57 [3.58~11.16], P<0.05) and APRI scores (3.77 [1.90~7.65], P<0.05). Multivariate analysis identified PLT (OR=0.991, 95% CI: 0.984~0.998, P=0.014) and ALB (OR=0.900, 95% CI: 0.820~0.988, P=0.027) as independent predictors of advanced fibrosis, suggesting that thrombocytopenia and hypoalbuminemia were associated with accelerated fibrogenesis. Conclusion Platelet count and albumin levels may serve as potential biomarkers for advanced hepatic fibrosis progression in AIH patients. Dynamic monitoring of these parameters could facilitate early identification of high-risk populations and optimization of individualized therapeutic strategies.

Key words: Autoimmune hepatitis, Advanced hepatic fibrosis, Platelet count, Albumin, Non-invasive biomarkers

孙微, 余虹, 窦婧, 王转国, 宁忠慧, 王晓波, 帕力达·帕拉哈提, 王晓忠, 郭峰. 自身免疫性肝炎合并进展性肝纤维化患者的影响因素分析[J]. 肝脏, 2026, 31(7): 954-957.

Sun Wei, Yu Hong, Dou Jing, Wang Zhuanguo, Ning Zhonghui, Wang Xiaobo, Palida Palahati, Wang Xiaozhong, Guo Feng. An analysis on the predicting factors of progressive liver fibrosis (≥F3) in autoimmune hepatitis patients[J]. Chinese Hepatolgy, 2026, 31(7): 954-957.

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