原发性胆汁性肝硬化206例临床病例分析

【目的】分析原发性胆汁性肝硬化（PBC）的临床特征，提高对该病的认识。【方法】回顾性分析206例PBC的一般资料、临床特征、各项生化指标和组织学特点。【结果1206例PBC患者中女性占86％（177／206），主要症状表现为乏力、皮肤瘙痒和纳差，主要体征是黄疸、脾大和肝大。大部分患者碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（y-GT）明显升高。无症状期患者血清白蛋白（ALB）、总胆红素（TBIL）和天门冬氨酸氨基转移酶（AST）水平与症状期患者比较，有统计学差异（P〈0．05）。200例患者（97％）血清抗线粒体抗体（AMA）和（或）抗线粒体抗体M2型（AMA-M2）阳性。31例行肝脏病理检查，主要表现为工期和Ⅱ期（72％）。【结论]PBC主要累及中老年女性，ALP、y-GT水平升高以及AMA和（或）AMA_M2阳性有助于本病的诊断，血清ALB和TBIL水平可能与疾病进展，甚至判断预后有关。

Clinical Analysis of 206 Patients with Primary Biliary Cirrhosis

LObjective]To analyze the clinical characteristics of primary biliary cirrhosis（PBC） and improve the understanding of the disease. Methods] The general data, clinical characteristics, biochemical indicators and histo logical features of 206 PBC patients were analyzed retrospectively. Results]Of 206 patients, females accounted for 86% （177/206）. The main symptoms were fatigue, pruritus and anorexia. The major signs were jaundice, spleno megaly and hepatomegaly. Serum levels of alkaline phosphatase （ALP） and 7glutamyl transpept~dase （~＇GT） were markedly elevated in most patients. There were significant differences in serum levels of albumin（ALB）, total biliru bin（TBIL） and aspartate amino transferase（AST） between symptomatic patients and asymptomatic patients（ P d0. 05）. Serum antimitochondrial antibody（AMA） and/or AMAM2 in 200 patients were positive. Liver function of 31 patients were grade I and grade 11 by pathological examination. Conclusion] PBC is mostly found in middle and elder ly women. The elevated levels of serum ALP and 7GT and positive AMA/AMA2 will be helpful for the diagnosis of PBC. Serum levels of ALB and TBIL may be related to the progression and prognosis of PBC.