摘要
目的探讨原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)的临床特征。方法回顾36例AMA阳性的PBC患者临床资料,同期住院的36例慢性乙型肝炎肝硬化(chronic hepatitis B virus-related cirrhosis,HBV-C)患者为对照组,分析两组患者的临床特点和生物化学指标。结果 PBC组以女性(83.3%)多见,平均年龄(53.5±11.5)岁,HBV-C组主要是男性(77.8%),平均年龄(56.4±12.8)岁。黄疸(66.7%)和乏力(63.9%)是PBC组的主要表现,HBV-C组以腹水(50.0%)和上消化道出血(38.9%)常见。HBV-C组的PLT和WBC水平较PBC组显著下降(P<0.01)。两组患者均有Hb和RBC水平明显降低,PBC组更明显,但两组间差异无统计学意义。ALT、AST、GGT、ALP、TBIL和DBIL水平在PBC组中均明显升高(P<0.05),而PT在HBV-C组显著延长(P=0.000)。血脂各项指标在Child-Pugh A级中,PBC组均高于HBV-C组,但差异无统计学意义;Child-Pugh B级中,TG、TC及LDL-C水平PBC组显著高于HBV-C组(P<0.05),而HDL-C水平在PBC组显著降低(P=0.006)。结论 PBC患者具有许多独特的临床特征,包括:①常合并其他自身免疫性疾病;②更容易发生黄疸和贫血;③反映胆管功能和胆汁代谢指标明显异常;④HDL-C的下降可能是反映PBC病情进展的良好指标。
Objective To investigate the clinical features of primary biliary cirrhosis（PBC）. Methods A total of 36 anti-mitochondrial antibody（AMA） positive PBC patients were included in this study,and compared with 36 chronic hepatitis B virus-related cirrhosis（HBV-C） patients in terms of clinical and biochemical features. Results Patients in PBC group were mainly females（83.3%） with the mean age of 53.5±11.5,and most of HBV-C group were males（77.8%） with the mean age of 56.4±12.8.The main symptoms and physical signs of PBC group were jaundice（66.7%） and fatigue（63.9%）,while ascites（50%） and upper gastrointestinal hemorrhage（38.9%） were most commonly seen in HBV-C group.HBV-C group had lower levels of platelet（PLT） and white blood cell（WBC）（P0.01）.Hemoglobin（Hb） and red blood cell（RBC） levels decreased in all patients especially those with PBC,however,there was no significant difference between two groups.Alanine aminotransferase（ALT）,aspirate aminotransferase（AST）,γ-glutamyltransferase（GGT）,alkaline phosphatase（ALP）,total bilirubin（TBIL）,direct bilirubin（DBIL） markedly elevated in PBC group（P0.05）,while prothrombin time（PT） significantly prolonged in HBV-C group（P=0.000）.Among Child-Pugh stage A patients,PBC group had higher levels of total cholesterol（TC）,triglyceride（TG）,lower density lipoprotein cholesterol（LDL-C） and higher density lipoprotein cholesterol（HDL-C） than HBV-C group,although with no significant difference.In Child-Pugh stage B PBC patients,the levels of TC,TG and LDL-C were much higher（P0.05）,while HDL-C level was lower（P=0.006）. Conclusion This study shows several characteristic clinical features of PBC,including： ① is commonly associated with other autoimmune diseases;② is more likely to suffer jaundice and anemia;③ has significant abnormal biochemical tests related to bile ducts function and bilirubin metabolism;④ HDL-C level may be a valuable marker of disease progression.
出处
《胃肠病学和肝病学杂志》
CAS
2012年第3期236-239,共4页
Chinese Journal of Gastroenterology and Hepatology
基金
辽宁省教育厅基金资助项目(2009A809)
关键词
原发性胆汁性肝硬化
肝功能
贫血
血脂
Primary biliary cirrhosis
Liver function
Anemia
Cholesterol
