肝脏
肝髒
간장
CHINESE HEPATOLOGY
2013年
10期
664-666
,共3页
周双男%张宁%苏海滨%高银杰%周霞%向轶%张敏
週雙男%張寧%囌海濱%高銀傑%週霞%嚮軼%張敏
주쌍남%장저%소해빈%고은걸%주하%향질%장민
原发性胆汁性肝硬化%临床表现%病理学
原髮性膽汁性肝硬化%臨床錶現%病理學
원발성담즙성간경화%림상표현%병이학
Primary biliary cirrhosis%Clinical manifestation%Pathology
目的总结原发性胆汁性肝硬化（PBC）患者的临床及病理学特点，以加深对该病的认识，指导临床诊疗。方法回顾性分析93例经肝活组织穿刺病理检查确诊为 PBC 患者的临床表现、生化指标、免疫学指标、病理学特点以及不同病理分期与生化指标相关性。结果93例患者临床症状中以乏力、皮肤瘙痒、黄疸最为常见。PBC 患者均有不同程度肝功能异常，以 ALP、GGT 升高最为多见，异常比例分别为94．6％、95．7％。69．9％患者血清 AMA 和（或）AMA-M2亚型阳性，64．5％患者 ANA 阳性。93例肝脏病理学检查，符合Ⅰ期为25例，Ⅱ期37例，Ⅲ期21例，Ⅳ期10例。病理分期与TBil、TBA 呈正相关，与 CHE 呈负相关（犘＜0．05）。结论诊断 PBC 应重视病理学检查，对病情及预后判断可参考 TBil、TBA、CHE 等指标，也应综合分析其临床症状、生化指标、自身抗体检测及组织学检查等。
目的總結原髮性膽汁性肝硬化（PBC）患者的臨床及病理學特點，以加深對該病的認識，指導臨床診療。方法迴顧性分析93例經肝活組織穿刺病理檢查確診為 PBC 患者的臨床錶現、生化指標、免疫學指標、病理學特點以及不同病理分期與生化指標相關性。結果93例患者臨床癥狀中以乏力、皮膚瘙癢、黃疸最為常見。PBC 患者均有不同程度肝功能異常，以 ALP、GGT 升高最為多見，異常比例分彆為94．6％、95．7％。69．9％患者血清 AMA 和（或）AMA-M2亞型暘性，64．5％患者 ANA 暘性。93例肝髒病理學檢查，符閤Ⅰ期為25例，Ⅱ期37例，Ⅲ期21例，Ⅳ期10例。病理分期與TBil、TBA 呈正相關，與 CHE 呈負相關（犘＜0．05）。結論診斷 PBC 應重視病理學檢查，對病情及預後判斷可參攷 TBil、TBA、CHE 等指標，也應綜閤分析其臨床癥狀、生化指標、自身抗體檢測及組織學檢查等。
목적총결원발성담즙성간경화（PBC）환자적림상급병이학특점，이가심대해병적인식，지도림상진료。방법회고성분석93례경간활조직천자병리검사학진위 PBC 환자적림상표현、생화지표、면역학지표、병이학특점이급불동병리분기여생화지표상관성。결과93례환자림상증상중이핍력、피부소양、황달최위상견。PBC 환자균유불동정도간공능이상，이 ALP、GGT 승고최위다견，이상비례분별위94．6％、95．7％。69．9％환자혈청 AMA 화（혹）AMA-M2아형양성，64．5％환자 ANA 양성。93례간장병이학검사，부합Ⅰ기위25례，Ⅱ기37례，Ⅲ기21례，Ⅳ기10례。병리분기여TBil、TBA 정정상관，여 CHE 정부상관（마＜0．05）。결론진단 PBC 응중시병이학검사，대병정급예후판단가삼고 TBil、TBA、CHE 등지표，야응종합분석기림상증상、생화지표、자신항체검측급조직학검사등。
Objective To summarize the clinical and pathological characteristics in patients with primary biliary cirrhosis (PBC),in order to get a better understanding of this disease and to guide the clinical diagnosis and treatment.Methods It was retrospectively analyzed that clinical manifestation,biochemical indexes,immunological and pathological characteristics,and correlation between pathological stage and biochemical indexes in 93 PBC patients diagnosed by liver biopsy.Results The most common symptoms of the 93 patients were fatigue,skin pruritus and jaundice.The biochemical indexes were abnormal in different degree.ALP and GGT were the most commonly abnormal indexes with the abnormal rates of 94.6% and 95.7% respectively.The positive rates of serum AMA and/or AMA-M2 were 69.9%,while 64.5% of patients have the positive results of ANA.As to the liver pathology,25 patients were at stage I,37 patients at stage II,21 patients at stage III,and 10 patients at stage IV.The pathological stages were positively correlated with TBil and TBA,and negatively correlated with CHE(犘<0.05 ).Conclusion We should pay attention to the examination of histopathology of PBC diagnosis.Judgement of the disease condition and prognosis can refer to the indexes of TBil,TBA,CHE,and compre-hensively analyze the clinical symptoms,biochemical indexes,autoantibody detection and histological examination.
