儿童风湿病是一组复杂的慢性炎症性疾病，主要包括幼年型特发性关节炎、弥漫性结缔组织病、系统性血管炎和自身炎症性疾病等。儿童风湿病合并肝脏病变较为常见，多数仅表现为不同程度的肝酶异常或肝肿大，可能不伴有显著的肝实质病变，且很少进展至肝功能失代偿期。极少数风湿病患儿可能出现严重的肝脏病变。儿童风湿病出现肝脏病变的病因可能是原发病本身引起，也可能是合并自身免疫性肝病所致，但更常见于治疗风湿病药物所致的药物性肝损伤、合并病毒性肝炎或脂肪肝等其他继发性因素。本文总结了常见的儿童风湿病合并肝脏病变，旨在为临床诊疗过程中的病因分析、诊断和治疗策略提供参考。

Pediatric rheumatic diseases are a group of complex chronic inflammatory disorders，mainly including juvenile idiopathic arthritis，diffuse connective tissue diseases，systemic vasculitis，and autoinflammatory diseases. Liver involvement is quite common in pediatric rheumatic diseases. In most cases，pediatric rheumatic diseases with liver involvement manifest as varying degrees of abnormal liver enzymes or hepatomegaly and may not have significant liver parenchyma lesions，and such diseases rarely progress to liver decompensation. Only a few children with rheumatic diseases may develop severe liver lesions. Liver involvement in children with rheumatic diseases may be caused by the primary disease itself or concurrent autoimmune liver diseases，but secondary factors are more common，including drug-induced liver damage caused by drugs used to treat rheumatic diseases，viral hepatitis，and fatty liver disease. This article summarizes liver involvement in pediatric rheumatic diseases，in order to provide a reference for the etiological analysis，diagnosis，and treatment strategies of liver involvement in pediatric rheumatic diseases.