原发性胆汁性胆管炎病理分期与各血清生化指标的相关性研究  

Correlation between Pathological Staging and Serum Biochemical Indexes of Primary Biliary Cholangitis

作　　者：章萍[1] 肖影群[1] 敖琴芳[1] ZHANG Ping;XIAO Yingqun;AO Qinfang(The Ninth Hospital of Nanchang City,Nanchang 330002,China;不详)

机构地区：[1]南昌市第九医院,江西南昌330002

出　　处：《中国医学创新》2021年第15期11-15,共5页Medical Innovation of China

摘　　要：目的:研究原发性胆汁性胆管炎(PBC)病理分期与血清生化的相关性,通过病理与临床生化相关性分析,深入对PBC的认识。方法:回顾性分析2015年1月-2020年12月于本院就诊的76例PBC患者的资料,所有患者均接受经皮肝脏穿刺活检确诊病情,并按照病理分期结果分为Ⅰ期(n=17)、Ⅱ期(n=19)、Ⅲ期(n=24)、Ⅳ期(n=16)。比较不同病理分期患者的一般资料、血清生化指标[总胆汁酸(TBA)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、甘胆酸(CG)、总蛋白(TP)、白蛋白(ALB)、γ-谷氨酰转移酶(γ-GT)]、免疫球蛋白(IgG、IgA、IgM)、凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]水平,应用Spearman相关系数分析不同指标与病理分期的相关性。结果:不同病理分期患者一般资料及TT、PT、APTT水平比较,差异均无统计学意义(P>0.05);Ⅰ期、Ⅱ期患者各项生化指标、免疫球蛋白指标水平比较,差异均无统计学意义(P>0.05);Ⅳ期患者TBA、AST、ALT、ALP、CG、γ-GT、IgG、IgA、IgM水平均高于Ⅲ期患者,TP、ALB、FIB水平均低于Ⅲ期患者,Ⅲ期患者TBA、AST、ALT、ALP、CG、γ-GT、IgG、IgA、IgM水平均高于Ⅰ期、Ⅱ期患者,TP、ALB、FIB水平均低于Ⅰ期、Ⅱ期患者(P<0.05);TBA、AST、ALT、ALP、CG、γ-GT、IgG、IgA、IgM与病理分期均呈正相关(P<0.05),TP、ALB、FIB与病理分期均呈负相关(P<0.05),TT、PT、APTT与病理分期均无相关性(P>0.05)。结论:PBC患者血清生化指标、免疫球蛋白及部分凝血功能指标均与病理分期存在相关性,体现了临床病理的一致性,病理与临床生化相结合,是深入认识PBC的重要途径。Objective:To study the correlation between pathological staging and serum biochemistry of primary biliary cirrhosis(PBC),and deeply understand PBC through correlation analysis between pathology and clinical biochemistry.Method:A retrospective analysis was performed on 76 PBC patients treated in the hospital from January 2015 to December 2020.All patients were diagnosed by percutaneous liver biopsy.According to the results of pathological staging,they were divided into stageⅠ(n=17),stageⅡ(n=19),stageⅢ(n=24)and stageⅣ(n=16).The general data,levels of serum biochemical indexes[total bile acid(TBA),aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),glycocholic acid(CG),total protein(TP),albumin(ALB),γ-glutamyl transferase(γ-GT)],immunoglobulins(IgG,IgA,IgM)and coagulation function indexes[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)]among patients with different pathological staging were compared.The correlation between different indexes and pathological staging was analyzed by Spearman correlation coefficients.Result:There were no significant differences in general data,TT,PT and APTT levels among patients with different pathological staging(P>0.05).There were no significant differences in the levels of different biochemical and immunoglobulin indexes between stagesⅠandⅡ(P>0.05).The levels of TBA,AST,ALT,ALP,CG,γ-GT,IgG,IgA and IgM in stageⅣwere higher than those in stageⅢ,while levels of TP,ALB and FIB were lower than those in stageⅢ(P<0.05).The levels of TBA,AST,ALT,ALP,CG,γ-GT,IgG,IgA and IgM in stageⅢwere higher than those in stagesⅠandⅡ,while levels of TP,ALB and FIB were lower than those in stagesⅠandⅡ(P<0.05).TBA,AST,ALT,ALP,CG,γ-GT,IgG,IgA and Ig M were positively correlated with pathological staging(P<0.05),while TP,ALB and FIB were negatively correlated with it(P<0.05).There were no correlation between TT,PT,APTT and pathological staging(P>0.05).Conclusion:The serum biochemical indexe

关 键 词：原发性胆汁性胆管炎 病理分期 生化指标 免疫球蛋白 凝血功能 

分 类 号：R575.7[医药卫生—消化系统]