不同组织学分期原发性胆汁性肝硬化患者临床特征分析

目的比较不同组织学分期原发性胆汁性肝硬化（PBC）患者的临床特征。方法回顾性分析39例组织学分期为早期和55例为进展期的PBC患者的人口学、实验室检查、影像学检查和预后指标（Mayo 风险评分、MELD评分、Child-Pugh评分），比较两组患者之间的差异。结果早期与进展期患者年龄构成比无显著性差异，但均以40～59岁居多；两组患者平均年龄、ALB、CHE、TBIL、PT、PLT、TC、IgG、MRS、MELD评分、Child-Pugh评分均具有显著性差异；腹水、食道或胃底静脉曲张发生率亦具有显著性差异（P〈0.05）；在早期患者仍可出现门脉高压的表现，出现腹水及食道静脉曲张的比例为7.7%；早期与进展期PBC患者乏力和瘙痒的发生率在两者之间无显著性差异（P〉0.05）；病理分期与MRS、MELD及Child-Pugh评分均具有相关性。结论早期PBC患者的预后优于进展期患者，但在PBC早期仍可出现门脉高压的表现，临床医生应予以重视。

Analysis of the clinical features of pati ents with primary biliary cirrhosis at different liver histological stages

Objective To compare the clinical features of patients with primary biliary cirrhosis（PBC）at dif-ferent liver histological stages. Methods The clinical characteristics of 39 patients with PBC at early liver histo-logical stages,and 55 patients with advanced stage of PBC were retrospectively analyzed,and the differences in de-mographics,laboratory tests,imaging checking-up and prognostic indicators （Mayo risk scores,MELD,Child-Pugh scores）between the two groups were compared. Results The percentages of age between the early and advanced stages were not statistically significant,and the majority of patients in both groups were 40 to 59 years old;There were statistically significant differences in mean age,ALB,CHE,TBIL,PT,PLT,TC,IgG,MRS,MELD and Child-Pugh scores between the two groups （P〈0.05）;The incidences of ascites and esophageal or gastric varices between the two groups were statistically significant（P〈0.05）;However,there were still 7.7% PBC patients at early histologi-cal stages of liver developed ascites and esophageal or gastric varices; The histological stages were significantly associated with the MRS,MELD and Child-Pugh scores（P〈0.05）. Conclusion Although patients with PBC at ear-ly liver histological stage may have a better prognosis than patients at advanced stages,they may also have portal hypertension and clinician should take this into consideration.