摘要
目的 :对原发性胆汁性肝硬化患者的临床特征进行回顾性分析 ,以提高对该病诊治的认识。方法 :分析 2 6例原发性胆汁性肝硬化患者的一般资料、临床表现、生化、免疫学及病理学等改变。结果 :本组患者中女性 2 4例 ,确诊时的平均年龄为 (5 9.3± 1.6 )岁。症状以黄疸最为多见 (76 2 % ) ,其次为皮肤瘙痒 (5 3 8% )和乏力 (5 0 % ) ,10例患者 (37 7% )合并腹水 ,7例患者 (2 6 9% )食道静脉曲张 ,5例患者伴随其他自身免疫性疾病 (19 2 % ,其中 3例干燥综合症 ,2例Graves病 )。所有患者血清碱性磷酸酶、γ谷氨酰转肽酶及胆红素水平明显升高 [分别为 (5 2 3 1± 72 6 )U/L、 (75 9 0± 2 0 4 7 1)U/L和 (2 90 0± 5 0 8) μmol/L],血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶 (AST)水平呈轻至中度升高 [分别为 (10 1 6± 2 7 1)U/L及 (197 8± 39 6 )U/L],患者血清IgM升高 (3 9± 0 4 )g/L ,行线粒体抗体检查者 81 8% (18/ 2 2 )阳性。结论 :原发性胆汁性肝硬化主要累及中年女性 ,血清碱性磷酸酶及γ谷氨酰转肽酶水平升高、抗线粒体抗体阳性、血清IgM升高有助于诊断本病 ,肝活检病理学检查有助于进一步确诊及组织学分期。
Objective:Clinical features of primary biliary cirrhosis(PBC) were reviewed in order to improve its diagnosis and treatment.Method The general conditions,clinical manifestations,biochemical and immunological changes,and pathological findings were assessed in 26 patients.Result cases were females,the mean age at definite diagnosis was(59.3±) years,Jaundice was the most frequent symptoms(76.2%),pruritus (53.8%) and fatigues(50%) were the second and third,respectively,Ten patients(37.7%) were complicated by ascites.Seven patients(26.9%) were complicated by oesophageal varicosis,Five patients(19.2%) had other associated auto-immune diseases such as Sjogren's syndrome(two patients) and Graves' diseases (three patients).Serum alkine phosphatase(ALP),giutamyltranspeptidase(r-GT) and bilirubin levels were markedly elevated[(523.1±72.6)U/L?(759.0±2047.1)U/L and (290.0±50.8)μ mol/L,respectively],ALT and AST levels were mildly or moderately elevated to 101.6±27.1U/L and 197.8±39.6U/L,most of patients had elevated serum immunoglobulin M(3.9±0.4g/L),81.8% of patients had positive anti-miltochondrial antibody(AMA).Conclusions PBC most frequently affects middle-aged women,The elevated level of ALP,r-GT and lgM and AMA positive may be crucial to diagnosis of PBC.Liver biopsy can help to identify the diagnosis and carry on pathological staging.
出处
《华西医学》
CAS
2004年第2期233-235,共3页
West China Medical Journal
