摘要
目的研究原发性胆汁性肝硬化(PBC)患者的临床表现与实验室特征。方法收集2002年11月1日至2015年3月31日在暨南大学附属第一医院诊断为PBC的住院病例,回顾性分析其临床表现与实验室特征。结果共纳入PBC患者36例,男女性别比为1∶3,中位年龄为53.5岁;以肝大(88.9%)、黄疸(69.4%)、乏力(66.7%)、腹胀(52.8%)为主要临床表现,老年患者腹胀、上消化道出血的发生率均高于青中年患者(P<0.05)。血清谷氨酰转肽酶(GGT)升高最为显著,其次为碱性磷酸酶(ALP),中位数值分别为正常值的7.1和2.4倍,同时伴有明显的胆汁淤积性黄疸,总胆红素(TBIL)、结合胆红素(DBIL)、非结合胆红素(IBIL)、总胆汁酸(TBA)的中位数值分别为正常值的4.8、6.2、3和10倍。患者血清抗线粒体抗体(AMA)、抗核抗体(ANA)、抗核胞膜糖蛋白210抗体(抗gp210)+抗可溶性酸性核蛋白抗体(抗Sp100)的阳性率分别为55.6%、58.3%和41.7%,IgM升高率为65.0%。结论PBC以中年女性多见,肝大、黄疸、乏力、腹胀为主要临床表现,老年患者病情较重;血清GGT、ALP等升高明显;AMA阳性率较既往研究结果低,联合抗gp210、抗Sp100检测有助于该病的诊断。
Objective To analyze the clinical and laboratory examination characteristics of patients with primary biliary cirrhosis（PBC） from the First Affiliated Hospital of Jinan University. Methods From November 2002 to March 2015,patients hospitalized for primary biliary cirrhosis at the First Affiliated Hospital of Jinan University were collected, and the clinical manifestation and laboratory test of cases with PBC were retrospectively analyzed. Results 36 cases with PBC were collected in the study, and the ratio of male to female was 1 ∶ 3, with the median age of 53.5 years old. The most frequent clinical symptoms were hepatomegaly（88.9%）, jaundice（69.4%）, fatigue（66.7%） and abdominal distension（52.8%）,and the incidence of abdominal distension and upper gastrointestinal hemorrhage was higher in elderly patients. Serum levels of GGT and ALP were increased obviously, with the median values of 7.1 times and 2.4 times, respectively, higher than the normal levels. Patients also showed significant cholestatic jaundice symptom, with the median levels of TBIL, DBIL, IBIL, and TBA of 4.8 times, 6.2 times, 3 times and 10 times higher than normal levels, respectively. The positive rates of serum AMA,ANA, and anti-gp210＋anti-Sp100 were 55.6%, 58.3%, 41.7%, respectively, and 65.0% patients had elevated serum IgM.Conclusion The study showed that PBC most frequently affects middle-aged women; the main clinical manifestations are hepatomegaly, jaundice, fatigue and abdominal distension, and the elderly patients gain more serious condition. Levels of GGT, ALP, et al were obviously elevated. The positive rate of serum AMA in this study was lower than that in the previous studies, and the combination of AMA with the anti-gp210 and anti-Sp100 detection may be helpful for the diagnosis of PBC.
出处
《热带医学杂志》
CAS
2016年第7期871-874,878,共5页
Journal of Tropical Medicine
