原发性胆汁性肝硬化47例临床剖析.docVIP

原发性胆汁性肝硬化47例临床剖析 　　【摘要】目的:分析原发性胆汁性肝硬化(PBC)患者的临床特征、病理学表现，提高对PBC诊治的认识。方法:分析47例PBC患者的一般资料、临床表现、生化指标、免疫学标志、影像学表现、肝组织病理学特点及治疗结果。结果:女性42例，男性5例，临床表现以乏力(39/4782.98%),纳差(43/4791.49%)，黄疸(34/47 72.34%)为主要表现，部分患者以皮肤瘙痒(15/4731.91%)为首发症状。肝功能改变ALP、GGT升高较ALT、AST明显，TBIL升高以DBIL为主，GLO、CHOL明显升高。免疫功能检查抗线粒体抗体M2亚型(AMA-M2)阳性。结论:PBC患者多见于中年女性，尤其血清中ALP、GGT、DBIL、GLB、CHO升高及AMA-M2阳性，有助于我们提高对PBC的认识及作出明确的诊断，病理学检查有助于进一步确诊，患者早期合用熊去氧胆酸治疗，短期内有一定疗效。 　　【关键词】 原发性胆汁性肝硬化；病理学；生化；抗线粒体抗体M2亚型 　　Clinical and pathological analysis of 47 patients with primary biliary cirrhosis 　　Ma Chun-ming,Zhou Gen-fa CHEN Guo-chun Wei Zheng 　　【Abstract】 Objective To summarize the clinicalfeatures of primary biliary cirrhosis (PBC). Methods In this study, we characterized 47 primary biliary cirrhosis patients of general information, clinical manifestations, biochemistry, immunology and liver tissue pathology. The results There were 42 women, 5 men in this study, the average age was (59.52±9.64) years old. Clinical manifestations were fatigue (39/47, 82.98%), anorexia (43/47, 91.49%), jaundice (34/47,72.34%) as the main performance, in some patients with pruritus (15/47, 31.91%) were the initial symptoms. The liver function results showed that serum ALP, GGT increased more significantly than ALT and AST; increased in DBIL was higher than IBIL；GLO, CHOL increased significantly. Immune function checks the AMA-M2 subtypes (AMA-M2)-positive. Conclusions PBC commonly occurs in middle-aged women, especially in the serum ALP, GGT, DBIL, GLO, CHOL increased and the AMA - M2 positive patients.The liver biopsy was important for dignosis of PBC.The therapy complicated of UDCA was helpful to the early stage PBC patients. 　　【Key words】 Primary biliary cirrhosis; Pathology; Biochemistry;AMA-M2 　　【中图分类号】R223 【文献标识码】B 【文章编号】1005-0515(2011)10-0033-03 　　 　　 　　原发性胆汁性肝硬化(Primary Biliary Cirrhosis, PBC)是器官特异性自身免疫性疾病，病理组织学出现肝脏门静脉炎症和肝内胆管免疫介导损伤，体内产生多种自身抗体为主要特点，肝内胆管进行性非化脓性破坏、慢性肝内胆汁淤积为主要特征的一种原因不明的慢性肝脏疾病。文献报道，中国PBC的发病率和死亡率明显高于世界其他地区［1］，PBC已成为我国