原发性胆汁性肝硬化及其合并干燥综合征的临床及实验室检查特点比较

Clinical symptom and laboratory examination of primary biliary cirrhosis combined Sjogren's syndrome

目的分析原发性胆汁性肝硬化(PBC)及其合并干燥综合征(SS)的临床表现及实验室检查特点,为临床诊断提供依据。方法回顾性分析63例PBC患者,其中50例单纯的PBC患者(单纯的PBC组)及13例PBC合并SS的患者(PBC/SS组)的临床资料和实验室指标。结果①PBC/SS组口干、眼干的临床表现明显高于单纯的PBC组;PBC/SS患者Shirmer试验及唾液流率的阳性率达100%和69.2%。②PBC/SS组的抗SSA、抗SSB及抗RNP抗体的阳性率明显高于单纯的PBC组(P<0.05)。③单纯PBC抗SSA抗体阳性组的总胆红素(TBIL)、直接胆红素(DBIL)水平明显高于抗SSA阴性组(P<0.05)。④PBC/SS组患者IgG、血沉(ESR)水平显著高于单纯的PBC组;而PBC/SS组的前白蛋白(PAB)水平明显低于单纯PBC组,差异有显著性(P<0.05)。结论 PBC患者合并SS发生率较高,抗SSA抗体和高IgG水平可能是PBC合并SS患者的血清学特征。

Objective To analyse the clinical manifestations and laboratory characteristic of primary biliary cirrhosis（PBC） combined with Sjogren＇s syndrome（SS）,and to provide the basis for clinical diagnosis.Methods The clinical date and laboratory parameters of 63 PBC patients were analyzed retrospetively,included 50 cases with PBC and 13 cases with PBC combined with Sjogren＇s syndrome.Results ① PBC/SS group had significantly higher rate of dry mouth and dry eyes in clinical manifestations compare to PBC group.The positive Schimer test and salivary flow rate in PBC/SS patients was 100% and 69.2% respectively.② PBC/SS group had significantly higher frequencies of anti-SSA,anti-SSB and anti-RNP antibody than those in PBC group（P0.05）.③ Anti-SSA positive group had significantly higher level of total bilirubin and direct bilirubin than those in anti-SSA negative group with PBC patients（P0.05）.④ IgG and ESR levels were significantly higher in the PBC/SS group than those in PBC group,but the level of PAB was lower（P0.05）.Conclusion The results suggest that PBC can be combined with SS,and anti-SSA antibodies and the level of IgG and ESR may be a characteristic serologic finding for SS in PBC.