熊去氧胆酸治疗原发性胆汁性胆管炎效果的评判

Efficacy assessment of ursodeoxycholic acid in the treatment of primary biliary cholangitis

目的:采用多种疗效判定标准,分析熊去氧胆酸(UDCA)治疗原发性胆汁性胆管炎(PBC)的临床效果。方法:回顾性研究初次接受UDCA治疗的466例PBC患者,收集患者治疗前和治疗1年内的临床相关资料,对患者治疗后的血清生化指标和生化应答率进行对比分析。结果:UDCA治疗1年后患者总体血清生化指标明显改善,依据不同疗效判定标准所得的生化应答率分别为64.38%(Barcelona标准)、57.73%(Paris 1标准)、44.64%(Paris 2标准)、32.19%(Ehime标准)、54.29%(Momah/Lindor标准)和86.91%(Rotterdam标准),进一步分析发现Paris 1标准、Paris 2标准和Momah/Lindor标准的应答符合率最高。结论:应采用多种标准综合评判UDCA的临床疗效。

Objective:To analyze the clinical efficacy of ursodeoxycholic acid(UDCA)in the treatment of primary biliary cholangitis(PBC)using different criteria to assess response to therapy.Methods:A total of 466 naive PBC patients were retrospectively reviewed.Changes in clinical features and biochemistries after therapy were assessed.Results:After 1 year of UDCA treatment,the overall blood biochemical parameters of the patients were improved significantly.The biochemical response rates according to different criteria were 64.38%(Barcelona criteria),57.73%(Paris 1 criteria),44.64%(Paris 2 criteria),32.19%(Ehime criteria),54.29%(Momah/Lindor criteria)and 86.91%(Rotterdam criteria)respectively.Further analysis found that the Paris 1,Paris 2 and Momah/Lindor criteria had the highest consistency rates.Conclusion:Multiple criteria should be used in combination to assess the response to UDCA therapy.