原发性胆汁性肝硬化85例实验室检测指标的分析

Analysis of laboratory parameters in 85 patients with primary biliary cirrhosis

目的探讨原发性胆汁性肝硬化(PBC)的免疫学实验诊断特点。方法观察85例PBC患者的临床表现,并分析有关实验室检查资料。结果本组患者临床症状不典型。所有患者γ-谷氨酰转移酶(GGT)升高,98.8%(84/85)的患者碱性磷酸酶(ALP)升高,87.1%(74/85)的患者总胆红素(TB il)和结合胆红素(CB il)升高,81.2%(69/85)的患者丙氨酸转氨酶(ALT)、78.8%(67/85)的患者门冬氨酸转氨酶(AST)、52.9%(45/85)的患者球蛋白(GLB)、95.7%(22/23)的患者总胆汁酸(TBA)、84.0%(21/25)的患者高密度脂蛋白胆固醇(HDL-C)升高。自身抗体检测有59例抗核抗体(ANA)阳性(69%),其中32例为核膜型,20例为着丝点型;85例患者抗线粒体抗体(AMA)均为阳性,其中80例(94.1%)AMA M2阳性。结论PBC无典型性临床症状,医生可以通过临床表现结合AMA,尤其是AMA M2的检测结果获得诊断信息。

Objective To study the immunological laboratory diagnosis features of primary biliary cirrhosis （PBC）. Methods Clinical and laboratory data of 85 patients with PBC were retrospectively analyzed. Results The patients with PBC in our group did not exhibit typical manifestations. Serum glutamyl transpeptidase （GGT） level was markedly elevated in all patients. 98.8% （84/85） had alkaline phosphatase （ALP） elevation, 87.1% （74/85） had total bilirubin （TBil） and connect bilirubin （CBil） elevation, 81.2% （69/85） had alanine aminotransferase （ALT） elevation, 78.8% （67/85） had aspartate aminotransferase （AST） elevation, 52.9% （45/85） had globulin （GLB） elevation, 95.7% （ 22/23 ） had total bile acids （TBA） elevation, 84.0% （ 21/25 ） had high density lipoprotein cholesterol （HDL-C） elevation. 59 patients expressed positive antinuclear antibodies （ANA）, all the patients expressed antimitochondrial antibodies （AMA） （80 AMA M2）. Conclusions The PBC patients do not exhibit typical clinical symptoms. The patients with PBC could be diagnosed by investigation of clinical features and detection of AMA, especially AMA M2.