原发性胆汁性肝硬化患者预后相关因素分析

Analysis of Factors Related with Prognosis in Patients with Primary Biliary Cirrhosis

背景:原发性胆汁性肝硬化(PBC)是一种相对罕见的肝脏疾病,国内关于PBC患者预后和生存率的研究较少。目的:分析影响PBC患者预后的相关因素。方法:纳入2007年1月～2011年5月新疆医科大学第一附属医院收治的PBC患者,采集22项可能与预后相关的因素,筛选复发相关因素,行多元Cox回归模型分析。结果:共151例患者纳入研究,患者1、2、5年生存率分别为93.1%、91.4%、89.2%。年龄、凝血酶原时间、凝血酶原时间活动度、血钠、高密度脂蛋白、低密度脂蛋白、总胆红素、白蛋白、γ-谷氨酰转移酶、腹水、食管胃底静脉曲张与PBC患者生存时间相关(P<0.05)。凝血酶原时间、血钠、总胆红素、白蛋白是PBC预后的独立相关因素(P<0.05)。结论:凝血酶原时间、血钠、总胆红素、白蛋白是影响PBC患者预后的重要因素。

Background： PBC is a relatively uncommon liver disease, the annual incidence rate is 2-24/million, and prevalence rate is 19-240/million. The ratio of female to male is 10： 1. Aims： To analysis the factors related with prognosis in patients with PBC. Methods： Patients with PBC from January 2007 to May 2011 at The First Teaching Hospital of Xinjiang Medical University were enrolled in this study. Twenty-two suspected factors were analyzed for identifying the prognosis-related factors, and analysis of Cox proportional hazard regression model was conducted. Result： A total of 151 eligible subjects were selected in this investigation. The overall 1, 2 and 5-year survival rates were 93%, 91% and 89%, respectively. Age, prothrombin time, prothrombin time activity, blood sodium, high-density lipoprotein, low density lipoprotein, total bilirubin, albumin, γ-glutamyl transpeptidase, ascites as well as esophageal and gastric varices were correlated with survival time of PBC （P〈0.05）. Prothrombin time, blood sodium, total bilirubin, albumin were identified as the independent prognosis-related factors （P〈0.05）. Conclusion： Prothrombin time, blood sodium, total bilirubin, albumin were significantly correlated with the prognosis of PBC.