中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2014年
4期
236-239
,共4页
韩莹%廖慧钰%刘燕敏%黄云丽%黄春洋%张小丹%赵鹏%陈哲
韓瑩%廖慧鈺%劉燕敏%黃雲麗%黃春洋%張小丹%趙鵬%陳哲
한형%료혜옥%류연민%황운려%황춘양%장소단%조붕%진철
肝硬化,胆汁性%病理学,临床%胆管消失综合征
肝硬化,膽汁性%病理學,臨床%膽管消失綜閤徵
간경화,담즙성%병이학,림상%담관소실종합정
Liver cirrhosis,biliary%Pathology,clinical%Vanishing bile duct syndrome
目的 总结合并胆管消失综合征(VBDS)的PBC患者与无VBDS的PBC患者临床、病理特点的异同.方法 总结105例肝穿刺活组织检查证实PBC患者的资料,根据肝组织病理分为VBDS组(28例)和无VBDS组(77例),分析症状、实验室检查及病理分期结果的特点.采用t检验、方差分析、Wilcoxon秩和检验、x2检验进行统计学分析.结果 VBDS组Mayo评分为(8.2±1.3),略高于无VBDS组(8.1±1.9),但差异无统计学意义(F=3.884,P=0.052);VBDS组TC(8±6)mmol/L高于无VBDS组(6±4)mmol/L,胆碱酯酶(5 226±2 054) U/L低于无VBDS组(5 861±2 759) U/L,差异均有统计学意义(F分别为4.453,6.468,P均＜0.05);VBDS组核孔蛋白复合体(gp210)阳性率(46％,6/13)高于无VBDS组(22％,12/54),特别是gp210强阳性率(39％,4/13)高于无VBDS组(20％,11/54);肝脏病理Ⅲ、Ⅳ期患者中胆管消失综合征的比例(61％,17/28)高于Ⅰ、Ⅱ期患者(39％,11/28).结论 原发性胆汁性肝硬化患者出现gp210阳性,特别是强阳性,胆碱酯酶、ALP、TBA明显升高,胆碱酯酶降低等情况,应警惕胆管消失综合征发生的可能性.
目的 總結閤併膽管消失綜閤徵(VBDS)的PBC患者與無VBDS的PBC患者臨床、病理特點的異同.方法 總結105例肝穿刺活組織檢查證實PBC患者的資料,根據肝組織病理分為VBDS組(28例)和無VBDS組(77例),分析癥狀、實驗室檢查及病理分期結果的特點.採用t檢驗、方差分析、Wilcoxon秩和檢驗、x2檢驗進行統計學分析.結果 VBDS組Mayo評分為(8.2±1.3),略高于無VBDS組(8.1±1.9),但差異無統計學意義(F=3.884,P=0.052);VBDS組TC(8±6)mmol/L高于無VBDS組(6±4)mmol/L,膽堿酯酶(5 226±2 054) U/L低于無VBDS組(5 861±2 759) U/L,差異均有統計學意義(F分彆為4.453,6.468,P均＜0.05);VBDS組覈孔蛋白複閤體(gp210)暘性率(46％,6/13)高于無VBDS組(22％,12/54),特彆是gp210彊暘性率(39％,4/13)高于無VBDS組(20％,11/54);肝髒病理Ⅲ、Ⅳ期患者中膽管消失綜閤徵的比例(61％,17/28)高于Ⅰ、Ⅱ期患者(39％,11/28).結論 原髮性膽汁性肝硬化患者齣現gp210暘性,特彆是彊暘性,膽堿酯酶、ALP、TBA明顯升高,膽堿酯酶降低等情況,應警惕膽管消失綜閤徵髮生的可能性.
목적 총결합병담관소실종합정(VBDS)적PBC환자여무VBDS적PBC환자림상、병리특점적이동.방법 총결105례간천자활조직검사증실PBC환자적자료,근거간조직병리분위VBDS조(28례)화무VBDS조(77례),분석증상、실험실검사급병리분기결과적특점.채용t검험、방차분석、Wilcoxon질화검험、x2검험진행통계학분석.결과 VBDS조Mayo평분위(8.2±1.3),략고우무VBDS조(8.1±1.9),단차이무통계학의의(F=3.884,P=0.052);VBDS조TC(8±6)mmol/L고우무VBDS조(6±4)mmol/L,담감지매(5 226±2 054) U/L저우무VBDS조(5 861±2 759) U/L,차이균유통계학의의(F분별위4.453,6.468,P균＜0.05);VBDS조핵공단백복합체(gp210)양성솔(46％,6/13)고우무VBDS조(22％,12/54),특별시gp210강양성솔(39％,4/13)고우무VBDS조(20％,11/54);간장병리Ⅲ、Ⅳ기환자중담관소실종합정적비례(61％,17/28)고우Ⅰ、Ⅱ기환자(39％,11/28).결론 원발성담즙성간경화환자출현gp210양성,특별시강양성,담감지매、ALP、TBA명현승고,담감지매강저등정황,응경척담관소실종합정발생적가능성.
Objective To compare the clinical and pathological differences of primary biliary cirrhosis (PBC) patients with and without vanishing bile duct syndrome (VBDS).Methods The data of 105 patients with PBC diagnosed as PBC by liver biopsy were collected.The cohort was divided into two groups:the VBDS group (28 cases) and non-VBDS group (77 cases) based on the presence or absence of VBDS in liverpathology.All data were analyzed for the characteristics of symptoms,clinical laboratory and patho-logical stages.T-test,ANOVA,Wilcoxon rank sum test,x2 inspection were used for statistical analysis.Results Mayo score of VBDS group was (8.2 ±1.3),which was slightly higher than that of the non-VBDS group (8.1±1.9,F=3.884,P=0.052).The TC [(8±6) mmol/L] level was significantly higher than that of the non-VBDS group [(6±4) mmol/L,F=4.453,6.468; P＜0.05].The gp210 positive rate of the VBDS group was 46％(6/13),which was higher than that of non-VBDS (22％,12/54).The strong positive rate (39％,4/13) was significantly higher in the VBDS group than that of the non-VBDS(20％,11/54) group.The proportion of stage Ⅲ,Ⅳ in liver pathology (61％,17/28) was higher than stage Ⅰ,Ⅱ in patients with vanishing bile duct syndrome than that (39％,11/28) of patients without.Conclusion The occurrence of VBDS should be considered when gp210 is positive,especially in patients with strong positive anti-gp210 antibody.Meanwhile,TC,ALP,TBA are significantly increased in primary biliary cirrhosis patients.
