原发性胆汁性肝硬化21例临床分析  

Clinical characteristics of 21 cases with primary biliary cirrhosis

作　　者：王春莉[1] 刘健虎[1] 谭晓风[1] 朱燕芳[1] 袁福兵[1] 

机构地区：[1]解放军第一○一医院感染病科,无锡214044

出　　处：《江苏医药》2009年第7期785-787,共3页Jiangsu Medical Journal

摘　　要：目的分析原发性胆汁性肝硬化(PBC)患者的临床和病理特征。方法回顾性分析21例PBC患者临床资料。结果21例患者中,女性19例,确诊时平均年龄(49.3±9.7)岁,从初诊到确诊间隔时间为9.6(1.5～22)年。常见临床表现多为乏力(90.5%),黄疸(85.7%),脾肿大(57.1%)。所有患者血清谷胺酰转肽酶(GGT)和碱性磷酸酶(ALP)均显著升高,分别为(879.0±199.5)U/L和(710.4±564.6)U/L,85.7%(18/21)患者血清抗线粒体抗体(AMA)和(或)AMA-M2亚型阳性。8例肝穿刺病理形态学改变主要为:小叶间胆管损伤87.5%(7/8)、碎屑样坏死75%(6/8)、纤维化62.5%(5/8)、胆色素聚集50%(4/8)等。结论PBC以中年女性多见,临床工作中需综合临床、生物化学、免疫学及病理检查及时正确诊断。Objective To investigate the clinical and pathological characteristics of primary biliary cirrhosis（PBC）. Methods Clinical data of 21 patiens with PBC were retrospectively analyzed. Results Among the 21 patients, 19 were women with a mean age of （49.3 ± 9.7） years old at diagnosis. The mean time interval between the first visit to physicians to the time of correct diagnosis was 9.6 （from 1.5 to 22）years. The most common clinical presentations were fatigue（90.5%）, jaundice（61.9%） and enlarged spleen （57.1%）. Serum glutamyl transpeptidase（GGT） and alkaline phosphatase（ALP） levels were markedly elevated in all patients [ （879± 199.5） U/L and （710. 4 ± 564.6） U/L）, respectively]. Of 21 cases, 18（85.7%） patients were positive for anti-mitochondrial antibody （AMA） and/or AMA-M2. Liver biopsy in 8 PBC patients showed interlobular bile duct lesions in 7 cases （87.5 %）, hepatocellular piecemeal necrosis with lymphocyte infiltration in 6 （75 % ）, fibrosis in 5（62.5%） ,and bile pigment accumulation in 4 （50%）. Conclusion PBC is mostly found in middle-aged women. A correct diagnosis of PBC should be based on the clinical presentations, biochemical and immunological indexes.

关 键 词：胆汁性肝硬化 抗线粒体抗体 谷胺酰转肽酶 碱性磷酸酶 

分 类 号：R575[医药卫生—消化系统]