原发性胆汁性胆管炎与肝硬化患者临床指标差异分析

目的 探讨原发性胆汁性胆管炎(PBC)与原发性胆汁性肝硬化患者临床指标的差异。方法 2015年5月～2021年9月我院诊治的PBC患者164例，其中胆管炎组70例，肝硬化组94例。收集临床指标，应用Logistic回归分析影响PBC患者疾病进展的相关危险因素。结果 本组肝硬化患者年龄为(58.6±13.0)岁，显著大于胆管炎组【(53.4±11.1)岁，P<0.05】;血清谷丙转氨酶、谷草转氨酶、碱性磷酸酶、总胆红素分别为49.7(27.5,80.2) U/L、62.6(44.9,114.7) U/L、156.8(126.5,230.5) U/L和31.5(17.6,88.4)μmol/L,显著高于胆管炎组【分别为39.3(23.9,66.0) U/L、36.4(26.8,63.4) U/L、126.5(94.8,187.3) U/L和14.6(10.0,24.3)μmol/L,P<0.05】;肝硬化组血清抗核抗体和抗gp210抗体阳性率分别为91.5%和43.6%,显著高于胆管炎组的80.0%和25.7%(P<0.05);肝硬化组血清IgG、IgA和IgM水平分别为...

Clinical feature of patients with primary biliary cholangitis and primary biliary cirrhosis

Objective The aim of this study was to compare the clinical feature of patients with primary biliary cholangitis and primary biliary cirrhosis. Methods 164 patients, including 70 with primary biliary cholangitis and 94 with primary biliary cirrhosis were encountered in the First Affiliated Hospital, Nanjing Medical University between May 2015 and September 2021, and their clinical materials were reviewed. The Logistic regression analysis was applied to investigate the risk factors for disease progression in this kind of patients. Result The age of the patients with cirrhosis was ( 58.6±13.0) year-old, significantly greater than [( 53.4± 11.1) year-old, P<0.05] in patients without cirrhosis; serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and total bilirubin levels in patients with cirrhosis were 49.7(27.5, 80.2) U/L, 62.6(44.9, 114.7) U/L, 156.8(126.5, 230.5) U/L and 31.5 (17.6, 88.4) μmol/L, significantly higher than [39.3(23.9, 66.0) U/L, 36.4(26.8, 63.4) U/L, 126.5(94.8, 187.3) U/L and 14.6(10.0, 24.3) μmol/L, respectively, P＜0.05] in patients with primary biliary cholangitis; the positive rates of serum anti-nuclear antibody and anti gp210 antibody in patients with primary biliary cirrhosis were 91.5% and 43.6%, significantly higher than 80.0% and 25.7%(P＜0.05) in patients with primary biliary cholangitis; serum IgG, IgA and IgM levels in patients with primary biliary cirrhosis were 17.0(13.2, 20.9) g/L, 3.5(2.5, 4.8) g/L and 2.9(2.0, 4.8) g/L, significantly higher than [14.2(12.7, 15.8) g/L、2.6(2.0, 3.4) g/L and 1.8(1.2, 3.3) g/L, respectively, P＜0.05], while serum C3 and C4 levels were 0.7(0.5, 0.9) g/L and 0.1(0.1, 0.2) g/L, significantly lower than [1.2(1.1, 1.4) g/L and 0.2(0.2, 0.3) g/L, respectively, P＜0.05] in patients with primary biliary cholangitis; the multivariate Logistic analysis showed that increased serum IgM and decreased C4 levels were the independent risk factors for the occurrence of liver cirrhosis (P＜0.05). Conclusion Some feature could hint the liver cirrhosis in patients with primary biliary cholangitis, out of them, higher serum IgM and low serum complement C4 levels might be the easy parameters.