多发性肌炎合并原发性胆汁性肝硬化十例临床分析  

Primary biliary cirrhosis associatied with polymyositis

作　　者：王立[1] 高丽霞[2] 张奉春[1] 

机构地区：[1]中国医学科学院北京协和医院风湿免疫科,100032 [2]河北医科大学第二医院风湿免疫科

出　　处：《中华风湿病学杂志》2011年第3期172-174,共3页Chinese Journal of Rheumatology

基　　金：基金项目：国家“十一五”科技支撑计划（2008BAl59803）

摘　　要：目的了解多发性肌炎（PM）合并原发性胆汁性肝硬化（PBC）的特点。方法回顾性分析1989年10月至2009年10月在北京协和医院住院的PM合并PBC的患者（PBC／PM）的特点；并与同期PBC数据库中未合并PM的PBC患者（PBC／nPM）进行比较。采用t检验X2或Fisher确切概率法。结果（1）PBC／PM共10例，占同期全部PBC患者的2．67％。②一般情况：10例PBC／PM男性3例，女性7例，平均年龄（54＋8）岁，男女比例、发病年龄与PBC／nPM组的差异无统计学意义（P〉0．05）；③临床特点及实验室检查：PBC／PM患者中心肌受累4例，呼吸肌受累2例。PBC肝功能Child—Pugh分级9例为A级；1例为C级。抗核抗体阳性10例，抗线粒体抗体（AMA）阳性10例，M2亚型（AMA—M2）阳性7例。红细胞沉降率（ESR）升高9例；④PBC／PM组与PBC／nPM组ESR差异有统计学意义（P=0．047）。结论PBC与PM并发并不少见，且并发者炎性水平较PBC单发者偏高。Objective To address the clinical features of the overlap of polymyositis （PM） and prim- ary biliary cirrhosis （PBC）, as well as its similarities to and differences from PBC/nPM patients. Methods Medical charts of 10 cases of PBC/PM inpatients admitted to Peking Union Medical College Hospital （PUMCH） from October 1989 to October 2009 were systemically reviewed. Two hundred and twenty-three cases were included as controls from the database of PBC patients in PUMCH at the same period by the statistic methods of t test, x2 test or Fisher exact test. Results （1） Ten （2.67%） PBC patients had concurrent PM. （2） Male/Female ratio in PBC/PM group was 3/7 and the age at diagnosis was （54_＋8） years. No significant differences between the two groupsin these data （P〉0.05）. （~ Clinical features and laboratory findings of PBC/ PM included： eardiomyopathy in 4 cases, respiratory muscle involvement in 2 cases, level A of Child-Pugh classification in 9 cases, level C in 1 case, positive antlnuclear antibody in 10 cases, positive anti-mito- ehondrial antibody in 10 cases, positive M2 subtype in 7 cases, elevated erythrocyte sedimentation rate（ESR） in 9 cases. （4） The significant difference between the two groups was ESR （P=0.047）. Conclusion The concurrence of PBC and PM is not rare, and the inflammation of PBC/PM is .likely more prominent than PBC/ nPM.

关 键 词：肝硬化 胆汁性 多发性肌炎 皮肌炎 

分 类 号：R575.2[医药卫生—消化系统]