中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
2期
118-120
,共3页
段维佳%张福奎%欧晓娟%张涛%王晓明%王宇%崔焱%赵新颜%贾继东
段維佳%張福奎%歐曉娟%張濤%王曉明%王宇%崔焱%趙新顏%賈繼東
단유가%장복규%구효연%장도%왕효명%왕우%최염%조신안%가계동
熊去氧胆酸%肝硬化,胆汁性%生物化学应答
熊去氧膽痠%肝硬化,膽汁性%生物化學應答
웅거양담산%간경화,담즙성%생물화학응답
Ursodeoxycholic acid%Liver cirrhosis,biliary%Biochemical response
目的 观察对熊去氧胆酸应答欠佳的原发性胆汁性肝硬化(PBC)患者的临床特点.方法 回顾性研究经熊去氧胆酸治疗1年以上的38例PBC患者,分析其在确诊时的性别、年龄及就诊时主要主诉;治疗前及治疗1年后的肝功能生化指标(血清ALT、AST、ALP、Y-谷氨酰转肽酶、总胆红素、白蛋白和球蛋白等);治疗前免疫学指标(IgG、IgM、血清抗核抗体和抗线粒体抗体).计量资料比较采用独立样本均数的t检验或近似法t'检验,计数资料的比较用Fisher's Exact Test.结果 38例PBC患者中,应答欠佳组患者17例,主要就诊原因为出现肝病相关症状,包括皮肤、巩膜黄染(41.1%),乏力、纳差(23.5%),下肢水肿、腹胀(11.7%)等.较好应答组患者21例,主要就诊原因为体检肝功能异常(33.3%).实验室检查结果显示,应答欠佳组与较好应答组相比,基线总胆红素[(40.15±25.08)μmol/L比(18.07±8.73)μmol/L]、碱性磷酸酶[(498.60±277.50)U/L比(313.70±182.10)U/L]、ALT[(105.60±69.22)U/L比(65.84±37.11)U/L]、AST[(113.80±54.24)U/L比(62.52±26.22)U/L]、球蛋白[(40.64±8.82)g/L比(33.06±5.01)g/L]和IgG[(19.52±4.44)g/L比(15.18±4.06)g/L]均较高,差异有统计学意义(t值分别为3.428、2.315、2.180、3.532、2.386和3.021,P值均＜0.05).结论 PBC患者中,因肝病相关症状就诊者、肝脏生物化学指标明显异常者以及自身免疫特征较多者,可能对熊去氧胆酸的应答欠佳.
目的 觀察對熊去氧膽痠應答欠佳的原髮性膽汁性肝硬化(PBC)患者的臨床特點.方法 迴顧性研究經熊去氧膽痠治療1年以上的38例PBC患者,分析其在確診時的性彆、年齡及就診時主要主訴;治療前及治療1年後的肝功能生化指標(血清ALT、AST、ALP、Y-穀氨酰轉肽酶、總膽紅素、白蛋白和毬蛋白等);治療前免疫學指標(IgG、IgM、血清抗覈抗體和抗線粒體抗體).計量資料比較採用獨立樣本均數的t檢驗或近似法t'檢驗,計數資料的比較用Fisher's Exact Test.結果 38例PBC患者中,應答欠佳組患者17例,主要就診原因為齣現肝病相關癥狀,包括皮膚、鞏膜黃染(41.1%),乏力、納差(23.5%),下肢水腫、腹脹(11.7%)等.較好應答組患者21例,主要就診原因為體檢肝功能異常(33.3%).實驗室檢查結果顯示,應答欠佳組與較好應答組相比,基線總膽紅素[(40.15±25.08)μmol/L比(18.07±8.73)μmol/L]、堿性燐痠酶[(498.60±277.50)U/L比(313.70±182.10)U/L]、ALT[(105.60±69.22)U/L比(65.84±37.11)U/L]、AST[(113.80±54.24)U/L比(62.52±26.22)U/L]、毬蛋白[(40.64±8.82)g/L比(33.06±5.01)g/L]和IgG[(19.52±4.44)g/L比(15.18±4.06)g/L]均較高,差異有統計學意義(t值分彆為3.428、2.315、2.180、3.532、2.386和3.021,P值均＜0.05).結論 PBC患者中,因肝病相關癥狀就診者、肝髒生物化學指標明顯異常者以及自身免疫特徵較多者,可能對熊去氧膽痠的應答欠佳.
목적 관찰대웅거양담산응답흠가적원발성담즙성간경화(PBC)환자적림상특점.방법 회고성연구경웅거양담산치료1년이상적38례PBC환자,분석기재학진시적성별、년령급취진시주요주소;치료전급치료1년후적간공능생화지표(혈청ALT、AST、ALP、Y-곡안선전태매、총담홍소、백단백화구단백등);치료전면역학지표(IgG、IgM、혈청항핵항체화항선립체항체).계량자료비교채용독립양본균수적t검험혹근사법t'검험,계수자료적비교용Fisher's Exact Test.결과 38례PBC환자중,응답흠가조환자17례,주요취진원인위출현간병상관증상,포괄피부、공막황염(41.1%),핍력、납차(23.5%),하지수종、복창(11.7%)등.교호응답조환자21례,주요취진원인위체검간공능이상(33.3%).실험실검사결과현시,응답흠가조여교호응답조상비,기선총담홍소[(40.15±25.08)μmol/L비(18.07±8.73)μmol/L]、감성린산매[(498.60±277.50)U/L비(313.70±182.10)U/L]、ALT[(105.60±69.22)U/L비(65.84±37.11)U/L]、AST[(113.80±54.24)U/L비(62.52±26.22)U/L]、구단백[(40.64±8.82)g/L비(33.06±5.01)g/L]화IgG[(19.52±4.44)g/L비(15.18±4.06)g/L]균교고,차이유통계학의의(t치분별위3.428、2.315、2.180、3.532、2.386화3.021,P치균＜0.05).결론 PBC환자중,인간병상관증상취진자、간장생물화학지표명현이상자이급자신면역특정교다자,가능대웅거양담산적응답흠가.
Objective To observe the characteristics of primary biliary cirrhosis (PBC) with a suboptimal biochemical response to ursodeoxycholic acid.Methods A total of 38 Chinse PBC patients (5male patients,33 female patients,average age 55 years old) with treatment of ursodeoxycholic acid in our hospital from January 1999 to January 2009 were erolled and studied retrospectively.Results 17 suboptimal biochemical responders mainly presented with liver diseases related symptoms including jaundice (41.1%),fatigue,anorexia (23.5%),edema and abdominal distension (11.7%).21 good biochemical responders mainly presented with abnormal liver function tests without symptoms.The suboptimal biochemical responders had significantly higher baseline levels of total serum bilirubin,alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,immunoglobulin G and globulin as compared to the good biochemical responsers.There were no differences in gender,age and the dose of UDCA.Conclusion PBC patients with liver diseases related symptoms,marked abnormal liver tests and characteristics of autoimmune hepatitis may have a suboptimal biochemical response to ursodeoxycholic acid treatment.
