摘要
目的探讨原发性胆汁性肝硬化(PBC)患者的临床特征,为其诊治提供参考依据。方法回顾性分析2005年10月至2016年11月西安交通大学第一附属医院收治的101例PBC患者临床资料。其中男7例,女94例;年龄17~80岁,中位年龄59岁。患者均签署知情同意书,符合医学伦理学规定。总结患者的年龄、性别、症状、体征等一般资料,分析入院后血常规、肝肾功能、凝血功能、自身抗体等诊断指标,以及治疗方式的选择。结果 PBC患者中女性占93.1%(94/101)。乏力、黄疸、呕血和黑便、皮肤瘙痒发生率分别占52.5%(53/101)、33.7%(34/101)、14.9%(15/101)、12.9%(13/101)。脾大、腹腔积液、肝病面容、蜘蛛痣体征分别占73.3%(74/101)、48.5%(49/101)、33.7%(34/101)、5.9%(6/101)。患者常出现三系细胞减少,血清ALT、AST、ALP、GGT、TB、DB异常和凝血功能障碍,其中DB异常发生率97.0%(98/101)。抗线粒体抗体(AMA)、抗核抗体(ANA)阳性率分别高达81.2%(82/101)、79.2%(80/101)。熊去氧胆酸等药物治疗占69.3%(70/101),肝移植占16.8%(17/101),其余对症治疗措施占13.9%(14/101)。结论掌握PBC的临床特征,有助于其早期诊断及治疗。
Objective To investigate the clinical characteristics of patients with primary biliary cirrhosis （PBC） and provide reference for the diagnosis and treatment of PBC. Methods Clinical data of 101 patients with PBC who were admitted to the First Affiliated Hospital of Xi＇an Jiaotong University between October 2005 and November 2016 were retrospectively analyzed. Among them, 7 cases were males and 94 were females, aged 17-80 years old with a median age of 59 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. General data such as age, gender, symptoms and physical signs were summarized. Diagnostic indicators after admission such as routine blood test, liver and renal function, coagulation function and autoantibody, and selection of therapy were analyzed. Results The percentage of females among PBC patients was 93.1%（94/101）. The incidence of asthenia, jaundice, hematemesis and melena, cutaneous pruritus was respectively 52.5%（53/101）, 33.7%（34/101）, 14.9%（15/101）, 12.9%（13/101）. The incidence of splenomegaly, peritoneal effusion, hepatic face and nevus araneus was respectively 73.3%（74/101）, 48.5%（49/101）, 33.7%（34/101） and 5.9%（6/101）. Pancytopenia, abnormal levels of serum ALT, AST, ALP, GGT, TB and DB, and coagulation dysfunction were constantly observed. The incidence of DB abnormality was 97.0% （98/101）. The positive rate of anti-mitochondrial antibody （AMA） and antinuclear antibody （ANA） was respectively up to 81.2%（82/101） and 79.2%（80/101）. Among all the treatment, drug therapy such as ursodesoxycholic acid accounted for 69.3%（70/101）, liver transplantation accounted for 16.8%（17/101） and other symptomatic therapies accounted for 13.9%（14/101）. Conclusions Mastering the clinical characteristics of PBC patients contributes to early diagnosis and treatment of PBC.
作者
毕建斌
李泽宇
顾静娴
苗润晨
张佳
杜肇清
曲凯
刘昌
Bi Jianbin Li Zeyu Gu Jingxian Miao Runchen Zhang Jia Du Zhaoqing Qu Kai Liu Chang.(Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710061, China)
出处
《中华肝脏外科手术学电子杂志》
CAS
2017年第4期316-319,共4页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
国家自然科学基金(81601672)
关键词
肝硬化
胆汁性
黄疸
抗体
抗核
抗线粒体
肝移植
脱氧胆酸
Liver cirrhosis, biliary
Jaundice
Antibodies, anfinuclear
Anfimitochondrial antibody
Liver transplantation
Deoxycholic acid
