CAJ | 학술논문

目的：探讨男性原发性胆汁性肝硬化（ PBC）患者的临床特点。方法回顾性分析2007年1月-2013年3月住院的25例PBC男性患者的首诊症状、肝功能、血清抗线粒体抗体（ AMA）亚型抗体（ M2、M4、M9）以及2例病理结果、治疗及随访情况。结果患者平均年龄（60．5±10．8）岁。主要的首诊症状为右胁不适13例（52％），尿黄4例（16％），腹胀3例（12％）等。生化异常以血清γ谷氨酰转肽酶（GGT）〔（394．7±310．5）U/L〕增高最明显。 GGT增高5倍以上的患者较多，与丙氨酸氨基转移酶（ ALT）、天冬氨酸氨基转移酶（ AST）、碱性磷酸酶（ALP）相比有统计学差异（u值分别为-2．796、-2．583、-3．466， P均＜0．05）；AMA-M2阳性占84％， AMA-M4阳性占36％， AMA-M9阳性占24％。结论男性PBC患者起病隐匿，常表现为GGT明显增高的慢性肝功能损害，AMA抗体亚型（M2、M4、M9）阳性是重要的诊断依据。
목적：탐토남성원발성담즙성간경화（ PBC）환자적림상특점。방법회고성분석2007년1월-2013년3월주원적25례PBC남성환자적수진증상、간공능、혈청항선립체항체（ AMA）아형항체（ M2、M4、M9）이급2례병리결과、치료급수방정황。결과환자평균년령（60．5±10．8）세。주요적수진증상위우협불괄13례（52％），뇨황4례（16％），복창3례（12％）등。생화이상이혈청γ곡안선전태매（GGT）〔（394．7±310．5）U/L〕증고최명현。 GGT증고5배이상적환자교다，여병안산안기전이매（ ALT）、천동안산안기전이매（ AST）、감성린산매（ALP）상비유통계학차이（u치분별위-2．796、-2．583、-3．466， P균＜0．05）；AMA-M2양성점84％， AMA-M4양성점36％， AMA-M9양성점24％。결론남성PBC환자기병은닉，상표현위GGT명현증고적만성간공능손해，AMA항체아형（M2、M4、M9）양성시중요적진단의거。
Objective To investigate the clinical characteristics of male patients with primary biliary cirrhosis ( PBC) .Methods The clinical data from 25 male patients admitted into our hospital form January 2007 to March 2013 were analyzed retrospectively , including their symptoms at initial diagnosis , hepatic function , and three anti-mitochon-drial antibody (AMA) subtypes anti -M2, anti -M4 and anti -M9.Results The average age of the patients were (60.5 ±10.8) years old.The main clinical manifestations included discomfort in the upper right side of the abdomen (13 cases, 52%), yellow urine (4 cases, 16%), and abdominal distension (3 cases, 12%).Liver function was char-acterized by the obvious rising of GGT [(394.7 ±310.5)U/L], which was statistically different from ALT, AST, and ALP (u: -2.796, -2.583, and -3.466, respectively, all P<0.05).The positive rates among the patients were 84%for AMA-M2, 36% for AMA-M4, and 24% for AMA-M9.Conclusion The onset of PBC is insidious in male patients, commonly characterized by chronic liver function damage like obviously elevated GGT , which can be diag-nosed according to the presence of positive AMA subtypes anti -M2, anti-M4, and anti-M9.