原发性胆汁性肝硬化患者临床指标变化与肝脏病理分期的回顾性分析

目的通过肝活检检测原发性胆汁性肝硬化（PBC）患者的病理分期,并对比血生化、自身抗体等指标进一步明确各期的生化特点,便于指导临床。方法所有患者采静脉血检查肝功,自身抗体,免疫球蛋白,所有患者进行肝脏活检,分析其肝脏病理分期。结果 43例患者血清抗线粒体抗体（AMA）及AMA-M2阳性为31例（72.1%）。27例（62.8%）ANA阳性,37例（86.1%）患者血清IgM水平升高。均有肝功能指标的明显异常,以GGT及ALP升高最明显。结论对胆酶增高而原因未明的肝病患者,早期自身免疫抗体及肝脏病理检查对原发性胆汁性肝硬化的诊断及治疗具有临床指导意义。

Retrospective analysis of the clinical and pathological characteristics of primary biliary cirrhosis

Objective To determine pathological stage of patients with primary biliary cirrhosis （PBC） by liver biopsy,and compare the blood biochemistry,autoantibodies and other indicators to further clarify the chemical and biological characteristics,so as to guide clinical treatment. Method Blood examination was performed to all patients for detection of their liver functions,self-antibodies and immune globulin; all patients underwent a liver biopsy for analysis of their liver pathological staging.Result Among all of the 43 patients,there were 27 cases （62.7%） of AMA and AMA-M2 （＋）,27 cases （62.8%） of ANA（＋） and 37 cases （86.1%） with elevated levels of serum IgM. Their indication of liver function were remarkable abnormal,with elevated GGTs and ALPs being the most obvious. Conclusion Analysis of autoantibodies,biochemical and pathological changes in early stage is of clinical significance in guiding the diagnosis and treatment of primary biliary cirrhosis.