摘要
目的总结原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)的临床特征及诊治经验。方法回顾性分析2007年6月—2012年6月在我院治疗的56例PBC患者的临床表现、生化指标、病理学检查结果、影像学检查结果以及对熊去氧胆酸(ursodeoxycholic acid,UDCA)的治疗反应。结果 56例PBC患者中男女比为1:4.09。主要临床表现为乏力、皮肤瘙痒、纳差和黄疸。所有患者碱性磷酸酶(ALP)和γ-谷氨酰转肽酶(GGT)均明显升高。50例(89.29%)患者的抗线粒体抗体(antimitochondri alantibody,AMA)和AMA-M2亚型阳性。26例行肝脏穿刺(肝穿)病理学检查的患者中,早期(Ⅰ～Ⅱ期)占69.23%,晚期(Ⅲ～Ⅳ期)占30.77%。56例经UDCA治疗3～6个月后,生化指标较治疗前均有明显改善。结论 PBC主要累及中年女性,其特征为ALP和GGT升高及AMA和AMA-M2亚型阳性,肝穿病理学检查可进一步确诊疾病及确定组织学分期,常规护肝加UDCA治疗效果确切。
Objective To summarize the clinical characteristics of primary biliary cirrhosis （PBC） and the experience in the diagnosis and treatment of the disease. Methods A total of 56 PBC patients, who were treated in our hospital from Jun. 2007 to Jun. 2012, were enrolled in the study. Clinical data including clinical manifestations, biochemical indicators, pathological findings, imaging findings and the response to ursodeoxycholic acid （UDCA） therapy were analyzed retrospectively. Results The ratio of male to female was 1：4.09. The most common symptoms were fatigue, pruritus, anorexia and jaundice. The levels of ALP and GGT of all the patients were elevated. Fifty patients （89.29%） were positive for antimitochondrial antibody （AMA）/AMA-M2. Of 26 patients undergoing liver biopsy, 69.23% were in early stage （stages I - lI ） and 30.77% in advanced stage （stages HI-IV）. After 3-6 months of UDCA therapy, liver function was improved significantly in all the patients. Conclusions PBC most frequently affects middle- aged women, and is characterized by elevated levels of ALP and GGT and AMA/AMA-M2 positive. Liver biopsy is useful for confirming the diagnosis and differentiating histopathological stages. The conventional therapy of protecting liver function plus UDCA therapy achieves definite efficacy.
出处
《传染病信息》
2013年第3期184-186,共3页
Infectious Disease Information
关键词
肝硬化
胆汁性
病理学
自身抗体
体征和症状
vliver cirrhosis, biliary
pathology
autoantibodies
signs and symptoms
