Comparative Study On Clinical Laboratory Determination Indicators And Pathological Features Of Autoimmune Hepatitis And Drug-induced Liver Diseases

Objective:To study and analyze the characteristics and differences of clinical laboratory determination indicators and liver histopathology between autoimmune hepatitis(AIH)and drug-induced liver disease(DILD).Methods:Thirty autoimmune hepatitis patients and forty-three drug-induced liver disease patients admitted to the Infection Department of the First Affiliated Hospital of Nanchang University from January 2012 to December 2017 were collected.The patients of autoimmune hepatitis were divided into AIH group,drug-induced liver disease patients were divided into DILD hepatocyte injury group and DILD non-hepatocyte injury group.The clinical data of AIH and DILD were collected and analyzed retrospectively,including general data,blood biochemistry,immunological indexes,blood routine and pathological results of liver biopsy.The measurement data of normal distribution are compared by t-test,the measurement data of non-normal distribution are compared by Wilcoxon test,the comparison of counting data by Fisher exact probability test,and the comparison of grade data by Mann-Whitney U test.Results:1.The proportion of women and the index of immunoglobulin G(IgG)in AIH group were significantly higher than those in DILD group(including DILD hepatocyte injury group and DILD non-hepatocyte injury group)(P < 0.05).2.The alanine aminotransferase(ALT),neutrophil/lymphocyte ratio(NLR)and albumin/globulin ratio(A/G)indexes of patients with AIH group were significantly lower than those of DILD hepatocyte injury group,and globulin(GLB)was greatly higher than that in DILD hepatocyte injury group(P < 0.001).3.The indexes of aspartate aminotransferase(AST),albumin(ALB)andneutrophil(NEUT)were significantly lower in the AIH group than those in the DILD hepatocyte injury group.The AST/ALT and alkaline phosphatase(ALP)levels were highly higher than that of the DILD hepatocyte injury group(P<0.05).4.The ALB and A/G levels in the AIH group were extremetly lower than that in the DILD non-hepatitis group.The GLB index was extremely higher than the DILD non-hepatocyte injury group(P<0.001).5.The NEUT and NLR levels were greatly lower in the AIH group than the DILD non-hepatocyte injury group,while ALT and AST/ALT levels were greatly higher than the DILD non-hepatocyte injury group(P<0.05).6.The scores of interface hepatitis,portal area inflammation and fibrosis in the AIH group were greatly higher than the DILD hepatocyte injury group(P<0.05).The interfacial hepatitis and fibrosis scores in the AIH group were greatly higher than the DILD non-hepatocyte injury group(P<0.05).Conclusion:Autoimmune hepatitis and drug-induced liver disease have significant differences in some blood biochemistry,blood routine,immunological and pathological indicators.