摘要
目的对76例原发性胆汁性肝硬化(PBC)患者进行临床分析,以提高对该病的诊治水平。方法观察PBC患者的临床表现、生化指标及病理特点,并进行统计学分析。结果 76例PBC患者,男与女之比为1∶5,平均年龄(53.2±15.2)岁。主要临床表现为黄疸(64%),乏力(60%),纳差(48%),皮肤瘙痒(25%)。大多数患者碱性磷酸酶(ALP)与γ谷氨酰转肽酶(GGT)均明显升高,48例患者(64%)胆红素有不同程度的升高,24例患者(32%)血清IgM升高,64%的患者抗线粒体抗体(AMA)及AMA-2M2亚型抗体阳性。共有68例患者行肝穿刺病理检查,早期病变占16.2%,晚期病变占83.8%。结论中年女性好发PBC,最常见的症状为黄疸,部分早期患者可无症状,ALP及GGT水平升高及抗线粒体抗体和(或)线粒体抗体M2亚型阳性有助于诊断本病,肝组织学检查可进一步确诊该病及组织学分期。
Objective Clinical features of primary biliary cirrhosis（PBC） were reviewed in order to improve its diagnosis in our clinical practice.Methods Clinical data of 76 patients with PBC were reviewed including the clinical manifestation,laboratory tests,pathological findings and the response to therapy.Results Twelve patients were males（16%）,sixtyfour patients were females（84%）,and the mean age at diagnosis was（53.2±15.2） years.The most frequently complained symptoms were jaundice（64%）,fatigue（60%）,anorexia（48%） and pruitus（25%）.Serum alkaline phos-phatase（ALP） andγglutamyl transpeptidase（GGT） levels were markedly elevated in majority patients,The serum total bilirubin level increased in fourty eight patients（64%）.Twenty four patients（32%） had elevated serum immunoglobin M（IgM）,and 64% of patients were antimitochondrial antibody（AMA）/AMA-M2 positive.sixty eight patients underwent pathological examinations,16.2% in early stage and 83.8% in advanced stage.Conclusion PBC most frequently affects middle-aged women and the main clinical manifestations are jaundice and some patients are asymptomatic at early stage.Elevated serum ALP and γ-GT levels together with positive AMA/AMA-M2 can help to diagnose.Liver biopsy is useful to confirm the diagnosis and differentiate histopathological stages.
出处
《中外医学研究》
2011年第15期15-16,共2页
CHINESE AND FOREIGN MEDICAL RESEARCH
