原发性胆汁性肝硬化75例临床分析

D. Dukova, I. Kotzev
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引用次数: 1

摘要

背景和目的:原发性胆汁性肝硬化是一种慢性、缓慢进展的胆汁淤积性肝病,其特征是小叶间胆管破坏,如果不治疗,可导致纤维化、肝硬化和肝功能衰竭。它在女性患者中更为常见,通常在生命的第五个十年被诊断出来。本研究旨在了解原发性胆汁性肝硬化患者的人口学、临床、生化和血清学特征及组织学分期。方法:回顾性分析2005年1月至2013年12月在我中心诊断为原发性胆汁性肝硬化的成人患者。资料收集包括人口统计学、临床特征、生化和血清学指标以及组织学分期。结果:75例患者被诊断为原发性胆汁性肝硬化,平均年龄55岁,范围19-83岁,其中92.0%为女性。最常见的症状是疲劳(40.0%)、瘙痒(40.0%)、黄疸(28.0%)和尿色深(26.7%)。20.0%诊断时无症状。48.0%的患者出现肝硬化。96%的病例抗线粒体抗体阳性。34.8%的患者抗核抗体阳性。10.6%存在重叠综合征。45.3%的患者行肝活检。结论:原发性胆汁性肝硬化的临床特征与国际文献报道相似,但诊断时有症状和肝硬化患者的比例较高。
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Clinical Analysis of 75 Patients with Primary Biliary Cirrhosis
Background and aims: Primary biliary cirrhosis is a chronic and slowly progressive cholestatic liver disease characterized by destruction of interlobular bile ducts, which if untreated, leads to fibrosis, cirrhosis and liver failure. It is more frequent among female patients and is usually diagnosed in the fifth decade of life. This study aims to determine the demographic, clinical, biochemical and serological characteristics and histological stage of patients with primary biliary cirrhosis. Methods: Retrospective analysis of the adult patients diagnosed with primary biliary cirrhosis at our center from January 2005 to December 2013 was performed. Data collection included demographics, clinical features, biochemical and serological markers, and histological stage. Results: 75 patients were diagnosed with primary biliary cirrhosis (mean age: 55 years, range: 19-83), of whom 92.0% were women. The most common symptoms at presentation were fatigue (40.0%), pruritus (40.0%), jaundice (28.0%) and dark urine (26.7%). 20.0% were asymptomatic at diagnosis. 48.0% of patients had cirrhosis at presentation. Positive antimitochondrial antibodies were found in 96% of cases. 34.8% of the patients were positive for antinuclear antibodies. Overlap syndromes were present in 10.6%. Liver biopsy was performed in 45.3% of the patients. Conclusions: The clinical features of primary biliary cirrhosis were similar to those reported in the international literature but with a high percentage of symptomatic and cirrhotic patients at diagnosis.
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