摘要
目的分析老年人原发性胆汁性肝硬化(PBC)的临床、生化、免疫学及病死率等特征。方法对1991年1月至2004年3月期间临床诊断PBC的108例患者进行回顾性分析,比较老年(≥60岁)和中青年患者的一般资料、临床表现、生物化学、免疫学及病死率等特征。结果确诊PBC时,28例老年患者的临床表现和中青年患者相似,老年组男性比例高于中青年组(214%对63%,P<001),老年组和中青年组的血清总胆红素水平分别为(376±265)μmol/L和(647±630)μmol/L(P<005),其他肝功能实验和免疫学指标等差异无显著性。随访期间,老年组肝病相关的死亡率明显高于中青年组(214%对25%,P<001)。结论和中青年患者比较,老年PBC患者肝病相关的死亡更为常见,提示年龄为影响PBC患者预后的一项重要因素。
Objective To evaluate clinical features and mortality of primary biliary cirrhosis (PBC) in the aged patients. Methods Clinical data of 108 patients diagnosed with PBC was reviewed. The diagnosis of PBC was made according to the 2000 practice guidelines of American Association for the study of liver Diseases (AASLD). Elderly patients (≥60 years) were compared in terms of clinical, biochemical, immunological features and mortality with younger patients (<60 years). Results Among the 108 patients, the initial diagnosis of PBC was made in 28 patients at an age ≥60. The elder patients had similar clinical manifestations, except for higher male/female ratio compared with younger patients (6/22 vs 5/75, P<0.01). The serum level of total and direct bilirubin was lower in elderly patients compared with that of younger patients [(37.6±26.5)μmol/L vs (64.7±63.0)μmol/L and (17.5±15.8)μmol/L vs (38.6±43.1)μmol/L, respectively, P<0.05], whereas there were no statistical differences in serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transpeptidase level and immunological findings between older and younger patients (P>0.05). After a median follow-up of 36 months, the mortality ratio for liver diseases was higher in the elderly than in younger group (21.4% vs 2.5%, ~P<0.01). Conclusions Elderly patients have similar clinical manifestations, liver biochemistry and immunological findings, but a higher mortality rate due to related diseases compared with younger patients. This suggests that old age may be an adverse risk factor for the prognosis of PBC.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2005年第1期18-20,共3页
Chinese Journal of Geriatrics
