原发性硬化性胆管炎临床与影像学分析

Clinical and imaging analysis of primary sclerosing cholangitis

目的研究原发性硬化性胆管炎临床与影像学表现及诊断线索：方法收集我院1987～2000年间经胆道造影术确诊的8例原发性硬化性胆管炎病例，其中男女各4例，平均诊断年龄46岁，从出现临床症状到就诊时的平均病程3．7年，分析患者的临床症状、体征及生化结果。结果阻塞性黄疸、体重减轻、搔痒是其主要就诊原因，大部分病人同时存在一种以上症状，生化指标以碱性磷酸酶升高最敏感。影像学表现为胆管轻度扩张、管壁粗糙、胆结石。结论硬化性胆管炎临床表现变化多端，对可疑病例应及时进行经内镜逆行胰胆管造影检查。

Aim To study clinical features of primary, sclerosing cholangitis （PSC） and clues of diagnosis. Methods This paper reports 8 cases of patients with PSC diagnosed at AnHui medical college accessory, hospital between 1987 - 2000, which have been confirmed by cholangiography. The 8 patients included 4 men and 4 women. The median age of the patients at the time of diagnosis was 46 years. The median history from the time of presentation to diagnosis was 3.7 years. In this present report, the clinical presentation and biochemical data in patients with PSC are analyzed. Results Major symptoms at diagnosis include obstructive jaundice,weight loss,and pruritus;one or more of the symptoms occur in most of our patients. Increases in serum alkaline phosphatase activity is the most effective and sensitive biochemical data available. Conclusions Our findings suggest that PSC appears to vary considerably from patient to patient. Endoscopic retrograde eholangiopancreatography （ERCP） should be screened in all patients whose signs and symptoms warrant PSC.