中文摘要：

目的研究原发性干燥综合征（pSS）合并肝损伤的临床和实验室特点，并分析其独立危险因素。方法对明确诊断为pSS的149例住院病例进行回顾性分析。结果149例pSS患者中合并肝损伤者17例（11．4％），其中10例（6．7％）诊断为自身免疫性肝炎，7例（4．7％）诊断为原发性胆汁性肝硬化。IgG、IgM和γ-球蛋白升高在有肝脏损伤的pSS患者和无肝脏损伤患者中分别占88．2％和50．8％，35．3％和5．3％，94．1％和47．7％，差异有统计学意义（均P〈0．05）。线粒体M2亚型抗体IgC在肝损伤患者中的阳性率（35．3％）高于无肝损伤患者（1．5％），P〈0．05。导致肝损伤的独立危险因素为：患者年龄（OR=1．013，95％CI：0．971～1．058），病程（OR=1．089，95％CI：1．032—1．150），7-球蛋白水平升高（OR=4．021，95％CI：1．246～12．982），线粒体M2亚型抗体IgG阳性（OR=11．82，95％CI：0．005—0．157），抗干燥综合征A（SSA）抗体阳性（OR=101．333，95％CI：12．653～811．560）。结论pSS患者肝损伤的发生率较高，IgG、IgM和γ-G升高对预测合并肝损伤有一定意义，患者病程、γ-球蛋白水平及线粒体M2亚型抗体IgG及SSA抗体阳性与肝脏受累相关。

英文摘要：

Objective To study clinical features of liver damage in primary Sjisgren syndrome （pSS） and its related factors. Methods One hundred and forty-nine patients of confirmed pSS hospitalized at Peking University People＇s Hospital were analyzed retrospectively. Results Seventeen of 149 patients of pSS （11.4%） showed liver damage, 10 diagnosed as autoimmune hepatitis and seven as primary biliary liver cirrhosis. Increased serum levels of IgG, IgM and γ-globulin accounted for 88. 2% and 50. 8%, 35.3% and 5.3%, and 94. 1% and 47.7% of those complicated with and without liver damage, respectively, with statistically significant difference （P 〈 0. 05 ）. Positive serum anti-mitochondria antibody subtype M2 （AMA-M2） was 35.3% in pSS patients with liver damage, significantly higher than that in those without liver damage （ 1.5% ） （P 〈 0. 05）. Independent risk factors significantly associated with liver damage included age （ OR = 1. 013, 95% CI 0. 971 - 1. 058 ）, course of illness （ OR = 1. 089, 95% CI 1. 032 - 1. 150）, serum level of T-globulin （ OR = 4. 021, 95% CI 1. 246 - 12. 982 ）, positive AMA-M2 （OR = 11.82, 95% CI 0. 005 - 0. 157）, and positive anti-SSA （ OR = 101. 333, 95% CI 12. 653 - 811. 560）. Conclusions Liver damage occurred rather high in pSS patients and increased serum levels of IgG, IgM,γ-globulin and anti-SSA can be used to predict their complication with liver damage. Age, course of illness, serum level of γ-globulin, positive AMA-M2 and positive anti-SSA are all significantly associated with liver damage in pSS patients.