原发性胆汁性肝硬化72例临床分析

Clinical survey of 72 patients with primary biliary cirrhosis

目的分析原发性胆汁性肝硬化(PBC)的临床特征,提高对该病的认识。方法回顾性分析72例原发性胆汁性肝硬化患者的临床表现、生化指标及免疫学指标。结果 72例原发性胆汁性肝硬化患者中女性与男性之比为6:1,临床主要表现为右上腹不适、乏力、尿黄等,所有患者均有不同程度的肝功能异常,以血清碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(γ-GT)升高为主,伴有胆红素升高。66例(91.7%)患者的抗线粒体抗体(AMA)、63例(87.5%)AMA亚型M2阳性。结论 PBC主要发病于中年女性,主要表现为右上腹不适、乏力及程度不同的黄疸,血清ALP、GT水平升高,AMA及AMA-M2亚型抗体阳性,血清IgM、IgG升高。

Objective Clinical features of primary biliary cirrhosis（PBC） were reviewed in order to improve its diagnosis in our clinical practice.Methods Clinical data of 72 cases with primary biliary cirrhosis were reviewed including the clinical manifestation,laboratory test.Results The ratio of female to male was 6：1,the most frequently complained symptoms were uncomfortable on right abdomen、fatigue、urinates yellow.Serum alkaline phosphatase（ALP） and γ-glutamyl transpeptidase（γ-GT） levels were markedly elevated in mostly cases.91.7% of patients（66/72） were Anti-mitochondrial antibody positive and 87.5% of patients（63/72） were Anti-mitochondrial antibody-M2 positive.Conclusion PBC most frequently affects middleaged women and the main clinic manifestations are uncomfortable on right abdomen,fatigue,urinates yellow.The elevated level of ALP,γ-GT and positive AMA/AMA-M2 may be crucial to diagnosis of PBC.