摘要
目的对70例原发性胆汁性肝硬化(PBC)患者的临床特征进行分析,提高对该病的认识。方法观察分析70例PBC患者的临床特征、各项生化指标和组织学特点并进行统计学分析。结果70例PBC患者中女性与男性之比为8∶1,平均年龄(53.1±10.4)岁。临床主要表现为皮肤瘙痒(60.0%)、乏力(42.9%)、纳差(41.4%)、黄疸(45.7%)。所有患者碱性磷酸酶(ALP)与γ谷氨酰转肽酶(GGT)均明显升高,65例患者(92.9%)胆红素有不同程度的升高。44例患者(62.9%)血清IgM升高。98.6%的患者抗线粒体抗体(AMA)及AMAM2亚型抗体阳性。共有41例患者行肝穿刺病理检查,早期(Ⅰ、Ⅱ期)占82.9%,晚期(Ⅲ、Ⅳ期)占17.1%。结论PBC主要累及中年女性,主要表现为皮肤瘙痒、乏力、纳差和不同程度黄疸,血清ALP和GGT水平升高、AMA及AMAM2亚型抗体阳性、血清IgM、IgG升高,该病应早诊断、早治疗。
Objective Clinical features of primary biliary cirrhosis （PBC） were reviewed in order to improve its diagnosis in our clinical practice. Methods Clinical data of 70 patients with PBC were reviewed including the clinical manifestation, laboratory tests, pathological findings and the response to therapy, Results Sixty-two patients were females （88. 6%）, eight patients were males （11.4%）, and the mean age at diagnosis was （53. 1 ± 10. 4） years. The most frequently complained symptoms were pruitus （60.0%）, fatigue （42.9%）, anorexia （41. 4%） and jaundice （45. 7%）. Serum alkaline phos phatase （ALP） and γ, glutamyl transpeptidase （GGT） levels were markedly elevated in all patients, while alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were mildly elevated. The serum total bilirubin level increased in sixty-five patients （92, 9%）. Forty-four patients （62. 9%） had elevated serum immunoglobin M （IgM）, and 98.6 % of patients （69/70） were antimitochondrial antibody （AMA） /AMA-M2 positive. Forty one patients underwent pathological examinations, 82.9%% in early stage （ Ⅰ , Ⅱ stage） and 17.1% in advanced stage （ Ⅲ , Ⅳ stage）. Conclusions PBC most frequently affects middle-aged women and the main clinical manifestations are pruritus, fatigue, anorexia and jaundice. The elevated level of ALP, GGT, IgM and positive AMA/AMA-M2 may he crucial to diagnosis of PBC.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2005年第7期391-393,共3页
Chinese Journal of Digestion
