| 原发性胆汁性胆管炎临床特征及红细胞分布宽度与血小板计数比值对肝硬化的诊断价值分析 |
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| 引用本文： | 刘新新,高春明,刘传苗. 原发性胆汁性胆管炎临床特征及红细胞分布宽度与血小板计数比值对肝硬化的诊断价值分析[J]. 中华全科医学, 2021, 19(3): 454-458. DOI: 10.16766/j.cnki.issn.1674-4152.001834 |
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| 作者姓名： | 刘新新 高春明 刘传苗 |
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| 作者单位： | 蚌埠医学院第一附属医院感染性疾病科,安徽 蚌埠 233004 |
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| 基金项目： | 安徽省教育厅高校自然科学基金KJ2017A247 |
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| 摘 要： | 目的 探究原发性胆汁性胆管炎(primary biliary cholangitis,PBC)的临床特征及红细胞分布宽度与血小板计数比值(RDW-to-platelet ratio,RPR)对PBC肝硬化期的诊断价值,提高临床医生对该病的诊疗水平.方法 收集2014年1月-2019年12月蚌埠医学院第一附属医院感染科门...
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| 关 键 词： | 原发性胆汁性胆管炎 肝硬化 红细胞分布宽度与血小板计数比值 抗线粒体抗体 |
| 收稿时间： | 2020-09-11 |
Clinical characteristics of primary biliary cholangitis and RPR value in diagnosing cirrhosis |
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| Affiliation: | Department of Infectious Diseases, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China |
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| Abstract: | Objective To investigate the clinical features of primary biliary cholangitis (PBC) and the value of red blood cell distribution width-to-platelet ratio (RPR) in diagnosing PBC progression to cirrhosis, as well as to improve the level of diagnosis and treatment of the disease by clinicians. Methods From January 2014 to December 2019, 61 patients were diagnosed as PBC in the Outpatient and Inpatient Department of the First Affiliated Hospital of Bengbu Medical College. The clinical data of the patients were retrospectively analysed. According to the diagnostic criteria of cirrhosis, it was divided into cirrhosis and non-cirrhosis groups. Blood routine, biochemical indices, RPR values, immunoglobulin, and complement levels were compared between the two groups. The diagnostic value of RPR for PBC cirrhosis was judged by the area under the working characteristic curve (AUC). Results Amongst the 61 patients with PBC, 47 were female (77.05%). The main clinical manifestations were jaundice (44.26%) and abdominal distension (24.59%). Sjogren's syndrome was the most common extrahepatic autoimmune disease. A total of 56 cases (91.80%) had abnormal liver function, primarily GGT increase. The positive rate of anti-mitochondrial antibody (AMA) and/or AMA-M2 was 93.44%. Significant differences were observed in RDW, PLT, RPR, and complement C3 and C4 between cirrhotic and non-cirrhotic groups. The AUC value of RPR in diagnosing liver cirrhosis was 0.705 (95% CI: 0.567-0.843; P=0.008). The best value was 0.471, and the sensitivity and specificity were 52.20% and 81.60%, respectively. Conclusion PBC usually occurs in middle-aged women, and jaundice is the most common clinical manifestation. The increase in ALP and GGT and the positive AMA are the main characteristics of the disease. Sjogren's syndrome is the most commonly associated extrahepatic autoimmune disease. RPR has a high specificity in diagnosing PBC progression to cirrhosis and can be combined with other non-invasive serological indicators to help evaluate the disease progress. |
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