原发性胆汁性肝硬化61例分析

Analysis of 61 cases with primary biliary cirrhosis

目的:总结原发性胆汁性肝硬化(PBC)患者的临床表现、实验室检查,以提高对该病的认识。方法:回顾性分析61例PBC和50例非原发性胆汁性肝硬化(自身免疫性肝炎8例,乙型肝炎22例,丙型肝炎10例,酒精性肝炎10例)患者的临床资料。结果:①61例患者中女性55例(90.1%),男性6例(9.9%),性别比例差异具有统计学意义(P<0.01);②61例患者中无症状者35例(57.4%),有症状者26例(42.6%),主要表现为皮肤瘙痒、乏力、消瘦;③61例患者血清抗线粒体抗体100%阳性,和非原发性胆汁性肝硬化组相比,差异具有统计学意义(P<0.01);④ALP、TBA和r-GT明显升高,而ALT和AST呈轻中度升高,TBil呈轻度升高。结论:PBC是一种慢性自身免疫性疾病,临床工作者应该加强对患者PBC的认识,重视对血清抗线粒体抗体的检测,尤其是长期原因不明、肝功能异常的女性患者。

Objective：To summarize the clinical manifestations,laboratory examination in primary biliary cirrhosis（PBC）,to raise awareness of the disease.Methods：Retrospective analysis was carried out on 61 cases with PBC and 50 patients with non-primary biliary cirrhosis（8 cases of autoimmune hepatitis,22 cases of hepatitis B,10 cases of hepatitis C,10 cas es of alcoholic hepatitis）.Results：①Among the 61 patients,55 cases were female（90.1%）,6 cases were male（9.9%）,with a significant difference（P〈0.01）;②Among 61 patients,35 cases（57.4%）were asymptomatic and 26 cases（42.6%） were symptoms,mainly for skin itching,fatigue and jaundice;③All of patients AMA were 100% positive and had a significant difference（P〈0.01）,comparing with non-primary biliary cirrhosis;④ ALP,TBA and r-GT were significantly higher,while ALT and AST were moderately higher,TBil slightly higher.Conclusion：PBC is an autoimmune disease.Clinical workers should strengthen the awareness of PBC and attach importance to the AMA detection,particularly for the long-term unexplained female patients with abnormal liver function.