慢性乙型肝炎合并原发性胆汁性胆管炎的临床特点

Clinical features of chronic hepatitis B combined with primary biliary cholangitis

目的观察24例慢性乙型肝炎(chronic hepatitis B,CHB)合并原发性胆汁性胆管炎(primary biliary cholangitis,PBC)患者的临床特征和预后。方法选取2010年1月至2022年12月在首都医科大学附属北京佑安医院就诊的CHB合并PBC患者。所有患者最初均因CHB就诊于我院。结果24例患者中女16例,男8例,女性占比66.7%,13例出现黄染或皮肤瘙痒症状,16例肝功能异常,以碱性磷酸酶(alkaline phosphatase,ALP)和r-谷氨酰转肽酶(r-Glutamyl transpeptidase,γ-GT)升高为主,24例患者抗线粒体抗体阳性。24例患者接受抗病毒和熊去氧胆酸治疗后,ALP和γ-GT水平明显下降(P=0.003,P=0.004)。结论CHB合并PBC患者接受抗病毒和熊去氧胆酸治疗后,不影响其生化应答及预后。

Objective To observe the clinical features and prognosis of 24 patients with chronic hepatitis B(CHB)combined with primary biliary cholangitis(PBC).Methods Patients with CHB combined with PBC attending Beijing You'an Hospital affiliated with Capital Medical University from January 2010 to December 2022 were selected.All patients initially presented to our hospital with CHB.Results In 24 patients,16 were women and 8 were men,with 66.7 percent women.Thirteen had symptoms of yellowing or itching,16 had abnormal liver function,predominantly elevated alkaline phosphatase(ALP)and r-glutamyl transpeptidase(γ-GT),and 24 patients were positive for anti-mitochondrial antibodies(AMA).ALP andγ-GT decreased significantly in 24 patients treated with antiviral and UDCA(P=0.003.P=0.004).Conclusion Treatment with antiviral and ursodeoxycholic acid in patients with CHB combined with PBC did not affect their biochemical response or prognosis.