70例原发性胆汁性肝硬化患者的临床特点分析

陆玮婷; 姜星火; 郭海燕; 赵建学

doi:10.3969/j.issn.1001-5256.2013.12.013

70例原发性胆汁性肝硬化患者的临床特点分析

DOI: 10.3969/j.issn.1001-5256.2013.12.013

江苏省中医院感染科

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中图分类号: R575.2
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出版历程
- 收稿日期: 2013-05-23
- 出版日期: 2013-12-20

Clinical features of primary biliary cirrhosis: a clinical analysis of 70 cases

Department of Infectious Diseases, Jiangsu Provincial Hospital of Traditional Chinese Medicine

摘要

摘要: 目的探讨原发性胆汁性肝硬化（PBC）患者的临床特点。方法回顾性分析2008年1月至2013年3月诊断为PBC的住院患者70例,记录患者的首诊症状、肝功能情况、AMA亚型抗体（M2、M4、M9）以及3例病理结果,并对ALT、AST、ALP、GGT增高的程度进行秩和检验,采用Wilcoxon法。结果 84.3%为女性患者,平均年龄（59.2±8.7）岁。主要的临床表现为乏力25.7%,皮肤瘙痒24.3%,右胁不适18.6%,腹胀18.6%。生化学异常以GGT[（324.5±250.4）U/L]、ALP[（381.1±259.0）U/L]增高最明显。GGT增高5倍以上的患者较多,与ALT、AST、ALP相比差异有统计学意义（u值分别为-5.861、-4.036、-4.445,P均为0.000）,AST、ALP增高2倍以上的患者亦较ALT多（u值分别为-4.405、-3.625,P均为0.000）。87.1%的患者AM2A阳性;AM4A阳性占31.4%,AM9A阳性占11.4%。结论 PBC是女性多见的以GGT、ALP增高为明显的慢性肝功能损害,AMA抗体亚型（M2、M4、M9）的阳性是诊断该...
- 肝硬化,胆汁性 /
- 自身免疫疾病
Abstract: Objective To investigate the clinical features of patients with primary biliary cirrhosis ( PBC) . Methods A retrospective analysis was performed on the clinical data of 70 inpatients diagnosed with PBC from January 2008 to March 2013. The initial symptoms, liver function, and antimitochondrial antibody ( AMA) subtypes ( M2, M4, and M9) of patients, as well as the pathological results of 3 cases, were recorded. The increases in alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , alanine phosphatase ( ALP) , and gamma-glutamyl transpeptidase ( GGT) were analyzed by Wilcoxon rank sum test. Results Of all patients, 84. 3% were females; the mean age was 59. 2 ± 8. 7 years. The main clinical manifestations included weakness ( 25. 7%) , itching ( 24. 3%) , discomfort in the upper right abdominal quadrant ( 18. 6%) , and abdominal distension ( 18. 6%) . Abnormal liver function was mainly characterized by significant increases in GGT ( 324. 5 ± 250. 4 U / L) and ALP ( 381. 1 ± 259. 0 U / L) . The number of patients with more than 5-fold increase in GGT was significantly higher than the numbers of patients with more than 5-fold increases in ALT, AST, and ALP ( u =-5. 861, P = 0. 000;u =-4. 036, P = 0. 000; u =-4. 445, P = 0. 000) . The numbers of patients with more than 2-fold increases in AST and ALP were significantly higher than the number of patients with more than 2-fold increase in ALT ( u =-4. 405, P = 0. 000; u =-3. 625, P = 0. 000) .Among all patients, 87. 1% were positive for antimitochondrial M2 antibody ( AM2A) , 31. 4% were positive for AM4A, and 11. 4% were positive for AM9A. Conclusion PBC, more common in females, is the chronic liver damage characterized by significant increases in GGT and ALP. Detection of AMA subtypes ( M2, M4and M9) is valuable for confirming the diagnosis of PBC.
- liver cirrhosis, biliary /
- autoimmune diseases

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