老年人原发性胆汁性胆管炎临床特征分析

Clinical characteristics of primary billiary cholangistis in elderly patients

目的探讨老年人原发性胆汁性胆管炎的临床特征。方法原发性胆汁性胆管炎患者,共121例,分为老年组及非老年组,老年组44例,非老年组77例;收集并比较两组PBC患者的临床资料、检验及影像检查资料。结果老年组中临床症状发生率最高的是乏力、黄疽,非老年组中为乏力、纳差,组间比较临床症状发生率差异不显著;老年组的TBIL、DBIL、ALT、AST、ALP、GGT平均值均略高于非老年组,但差异无统计学意义;自身免疫抗体检验结果显示,PBC患者检出率最高的是AMA、AMA-M2及ANA抗体。老年组中AMA、AMA-M2、Gp210、Sp100的检出率略高于非老年组,ANA的检出率低于非老年组,但差异无统计学意义。结论老年人原发性胆汁性胆管炎确诊晚,发现时大部分均已进入症状期以后,表现为乏力、黄疽、纳差等,肝硬化、腹水的发生率高。但与非老年组相比差异不显著。

Objective To discuss the clinical characteristics of primary billiary cholangistis in elderly patients. Methods 121 patients with primary billiary cholangistis were enrolled in the study： 44 cases in elderly group and 77 cases in non- elderly group; the clinical data of the cases in the 2 groups were collected and analyzed. Results The highest occurrences of clinical symptoms in elderly group were fatigue and jaundice while those in non-elderly group were fatigue and poor ap- petite, the difference between the 2 groups was of no statistical significance; the average values of TBIL, DBIL, ALT, AST, ALP and GGT of the patients in elderly group were slightly higher than those in non-elderly group, the difference between the 2 groups was of no statistical significance; the detection rates of AMA, AMA-M2, Gp210 and Spl00 in elderly group were slightly higher than those in non-elderly group while the detection rate of ANA in elderly group was lower than that in non-elderly group, the differences between the 2 groups were of no statistical significance. Conclusions The diagnosis of primary billiary cholangistis in the elderly is often confirmed late, usually until the onset of symptoms： fatigue, jaundice and poor appetite, the occurrences of cirrhosis and ascites are high, but there exists no obvious difference between the elderly patients and the non-elderly patients.