抗线粒体抗体-M2阳性体检人群与原发性胆汁性肝硬化患者相关临床特征横断面比较

The clinical characteristic comparison of primary biliary cirrhosis between population of physical examination and patient with anti-mitochondrial antibody-M2 positive

目的:比较抗线粒体抗体-M2(AMA-M2)阳性体检人群与住院患者临床特点,探讨两组人群与原发性胆汁性肝硬化(PBC)相关的临床症状及实验室检测指标的关系,以加强对PBC的认识,提高早期确诊率。方法:收集2009年1月—2013年12月我院住院患者AMA-M2阳性病历669份,2010年2月—2012年10月间本地区常住人口健康体检AMA-M2阳性档案156份。组间差异比较采用2检验,<0.01为差异有统计学意义。结果:两人群血常规异常率(62.78%46.15%)肝功能异常率(57.1%42.31%)总体比较差异较大,有统计学意义;但具有诊断价值的ALP、GGT两个酶类差异较小,无统计学意义;两人群早期临床症状如腹部不适、疲倦乏力、贫血等发生率差异也无统计学意义;两组人群胆囊病史、糖尿病病史、过敏史发生率均较高,但差异不显著,无统计学意义;就诊组晚期症状黄疸及早期症状发作频率和程度明显高于体检组,差异有统计学意义。就诊组男女比例明显高于体检组(1:2.14 1:3.88)差异有统计学意义。结论:通过两组人群比较显示AMA-M2阳性做为PBC特异性指标具有早期诊断价值,揭示PBC存在持续性加重的发生发展过程。对于实验室检测血常规异常、肝功异常,主诉消化不良、疲劳乏力等人群及早行AMA-M2等自身抗体的检测,有利于PBC的早期确诊。

Objective：To compare the clinical characteristic of primary biliary cirrhosis（PBC）between population of physical examination and patient with anti- mitochodrial antibody-M2（AMA-M2） positive, for enhancing the understanding of PBC and improving the rate of early diagnosis. Methods： A total of 669 cases patients with positive AMA-M2 and 156 cases of health examination with positive AMA-M2 in our hospital from January 2009 to December 2013 were collected. The comparison between two groups was analyzed by Х^2 test andP〈 0.01 was considered statistically significant differences. Results： There were statistically significant differences between physical examination population and patient in abnormal rate of blood routine test（62.78% vs46.15%）, liver function detection（57.1%vs 42.31%） and the incidence of late jaundice. There were not statistically significant differences between physical examination population and patient in the early clinical symptoms, such as abdominal discomfort, fatigue, anemia and so on, and the incidence of cholecystopathy history, diabetes history and allergy history. Conclusions： The serum AMA-M2 positive people showed a progressive in the anomaly ratio and severity. The clinical symptoms were intermittent seizures of PBC, and AMA-M2 detection was helpful in early diagnosis of PBC in the population of abnormal blood routine test and liver function detection associated with dyspepsia and fatigue.