原发性胆汁性肝硬化37例分析

Clinical Analysis of 37 Cases with Primary Biliary Cirrhosis

目的探讨原发性胆汁性肝硬化(PBC)患者的临床特征。方法分析37例原发性胆汁性肝硬化患者的一般资料、临床表现、生化指标、免疫学标志及肝组织病理学特点。结果临床表现以乏力(33/37,89.18%),纳差(34/37,91.89%),黄疸(29/37,78.37%)为主要表现,部分患者以皮肤瘙痒(12/37,32.43%)为首发症状。肝功能改变ALP、GGT升高较ALT、AST明显,TBIL升高以DBIL为主,GLB、CHO明显升高。免疫功能检查抗线粒体抗体M2亚型(AMA-M2)阳性。结论 PBC患者多见于中年女性,血清中ALP、GGT、DBIL、GLB、CHO升高及AMA-M2阳性,有助于PBC诊断。

Objective To study the clinical features of primary biliary cirrhosis（PBC） in order to facilitate cognition of the disease. Methods General status,clinical manifestations and laboratory findings and pathological features of 37 patients with PBC were reviewed. Results The most frequent symptoms were fatigue（33/37,89.18%） ,then pruritus（34/37,91.89%） and jaundice（29/37,78.37%） ,some patients（12/37,32.43%） were pruritus at early stage. The levels of serum alkailne phosphatase（ALP） and serum gamma glutamyl transpeptidase（GGT） were very high. Serum AMA-M2 was one of the most important indexes in the diagnosis of PBC. The main histopathological changes focused on small bile duct,inflammatory cell infiltrated around them,infiltration of cell was in header,different stages might be merged. Conclusion PBC is mostly found in middle-aged women. The most frequent symptoms are fatigue and pruritus,jaundice,elevated serum ALP,GGT,DBIL,GLB,CHO levels together with positive AMA-M2 can help to diagnose PBC.