摘要
目的:探讨原发性胆汁性胆管炎(PBC)患者中对熊去氧胆酸(UDCA)治疗反应欠佳的相关独立危险因素,并在PBC患者中验证UDCA疗效评分(URS)的预测效能。方法:纳入接受UDCA治疗且随访时间至少12个月的PBC患者,计算基线URS。采用Logistic回归模型确定对UDCA治疗反应欠佳的独立危险因素。结果:在194例UDCA治疗的PBC患者(中位年龄52.0岁,男10.3%,女89.7%)中,136例(70.1%)患者治疗有效。合并食管胃底静脉曲张和基线碱性磷酸酶(ALP)升高是UDCA疗效不佳的独立危险因素。URS预测PBC患者UDCA单药和联合治疗预后的受试者操作特征曲线下面积(AUC)分别为0.859和0.910。抗线粒体抗体(AMA)和抗gp210抗体阴性的PBC患者AUC高于AMA和抗gp210抗体阳性患者。结论:URS对新诊断的PBC患者UDCA治疗有效性上具有良好的预测价值,尤其在抗体阴性的亚组中。
Objective:To identify the related independent risk factors of inadequate response to ursodeoxycholic acid(UDCA)and to validate the UDCA response score in a cohort of Chinese primary biliary cholangitis(PBC)patients.Method:PBC patients who initiated UDCA treatment and had at least 12 months of follow-up data were included.Baseline UDCA response score was calculated.Logistic regression models were performed to identify the independent risk factors of incomplete biochemical response to UDCA.Results:Among the 194 UDCA-treated PBC patients(mean age 52.0 years,males 10.3%,females 89.7%),136(70.1%)patients showed a response.The combination with esophagogastric varices and elevated baseline alkaline phosphatase(ALP)were the independent risk factors of suboptimal response to UDCA.The AUC was 0.859 for treatment response of UDCA monotherapy,and 0.910 for PBC patients receiving combination therapy.As for PBC patients with negative anti-mitochondrial antibody(AMA)and anti-GP210 antibody,the AUC was greater than that with positive AMA and anti-GP210 antibody.Conclusion:Our results demonstrated that the UDCA response score had good predictive value in newly diagnosed Chinese PBC patients,especially in antibody-negative subgroups.
作者
吴学芬
蔡邵哲
董凌莉
叶丛
WU Xue-fen;CAI Shao-zhe;DONG Ling-li;YE Cong(Department of Rheumatology and Immunology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)
出处
《内科急危重症杂志》
2025年第3期215-219,共5页
Journal of Critical Care In Internal Medicine
基金
国家自然科学基金资助项目(82271847)
湖北陈孝平科技发展基金会(CXPJJH11800005-07)
华中科技大学第二临床学院教学研究基金(TJJXYJ2023045)。
