原发性胆汁性肝硬化患者血清特点及相关分析

Serological characteristics and correlative analysis of primary biliary cirrhosis

目的探讨原发性胆汁性肝硬化(PBC)患者肝功能及血清免疫学特征并对其相关性进行分析。方法回顾性分析河南省人民医院90例PBC住院患者资料,另选取同期健康体检者120例为对照组,2组对象进行比较。结果与对照组相比,PBC组血清ALT、AST、TBIL、DBIL、IBIL、ALP、γ-GGT、GLO、RDW、Ig G、Ig M及Ig A明显升高,ALB、C3、C4明显降低,差异均有统计学意义(P<0.05);PBC组ALT与AST和γ-GGT呈正相关(P<0.05),AST与ALP、γ-GGT、TBIL、DBIL和IBIL呈正相关(P<0.05),GLO与Ig G和Ig A呈正相关(P<0.05),DBIL、IBIL与TBIL之间两两呈正相关(P<0.05),ALP与γ-GGT及C3与C4之间呈正相关(P<0.05),ALB与DBIL、IBIL和TBIL呈负相关(P<0.05)。结论PBC患者有明显的肝功能紊乱,多种肝功能指标间明显相关,PBC发生发展过程中有多种机制参与;PBC患者胆红素代谢异常尤为显著,与AST和ALB等指标间相关关系具有相对独立性,是疾病严重程度的关键指标;PBC组血清Ig A、Ig M和Ig G明显升高,C3、C4明显下降,体液免疫在其发生发展过程中有重要作用。

Objective To explore the serological characteristics and analyse their correlations of primary biliary cirrhosis（ PBC）.Methods The data of 90 inpatients with PBC in Henan Province People＇ s Hospital were retrospectively analyzed and compared with the data of 120 healthy controls. Results Compared with the normal controls,the serum levels of ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GGT,GLO,red cell distribution width（ RDW）,Ig G,Ig M and Ig A were significantly higher while ALB,C3 and C4 were significantly lower in PBC patients,with the differences statistically significant（ P 0. 05）. In the PBC group,ALT was positively correlated with AST and γ-GGT（ P 〈0. 05）. AST was also positively correlated with ALP,γ-GGT,TBIL,DBIL and IBIL（ P 〈0. 05）. GLO was positively correlated with Ig G and Ig A（ P 〈0. 05）. DBIL and IBIL had positive correlation with TBIL respectively（ P〈 0. 05）. ALP was positively correlated with γ-GGT,so was it between C3 and C4（ P 〈0. 05）. While ALB was negatively correlated with DBIL,IBIL and TBIL（ P 〈0. 05）. Conclusion There were obvious liver function disorders in PBC patients. Significant correlations were found among liver function indexs of the PBC. The abnormal metabolism of bilirubins was particularly significant,which had significant correlations with AST and ALB independently,and which was the key indexs to the severity of the disease. The serum levels of Ig A,Ig M and Ig G significantly increased in PBC patients,while that of C3 and C4 significantly decreased,indicating the important role of humoral immunity in the occurrence and development of PBC.