原发性胆汁性肝硬化93例临床及病理特点分析-论文.pdf

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1、664·ChineseHepatology，Oct．2013，Vo1．18，No．10··论著·原发性胆汁性肝硬化93例临床及病理特点分析周双男张宁苏海滨高银杰周霞向轶张敏【摘要】目的总结原发性胆汁性肝硬化(PBC)患者的l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

2、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(P

3、imarybiliarycirrhosisZHOUShuang—nan，ZHANGNi，SUHai—bin，GAOYinie，ZHOUXia，XIANGYi，ZHANGMin．PLA302Hospital，Beijing100039，ChinaCorrespondingauthor：ZHANGMin，Email13911517721@163．com[Abstract]ObjectiveTosummarizetheclinicalandpathologicalcharacteristicsinpatientswithprimarybilia

4、rycirrhosis(PBC)，inordertogetabetterunderstandingofthisdiseaseandtoguidetheclinicaldiagnosisandtreatment．MethodsItwasretrospectivelyanalyzedthatclinicalmanifestation，biochemicalindexes，immunologicalandpathologicalcharacteristics．andcorrelationbetweenpathologicalstageandbi

5、ochemicalindexesin93PBCpatientsdiagnosedbyliverbiopsy．ResultsThemostcommonsymptomsofthe93patientswerefatigue，skinpruritusandjaundice．Thebiochemicalindexeswereabnormalindifferentdegree．ALPandGGTwerethemostcommonlyabnormalindexeswiththeabnormalratesof94．6and95．7respectively

6、．ThepositiveratesofserumAMAand／orAMA—M2were69．9，while64．5ofpatientshavethepositiveresultsofANA．Astotheliverpathology，25patientswereatstageI，37patientsatstageII，21patientsatstageIII，and10patientsatstageIV．ThepathologicalstageswerepositivelycorrelatedwithTBilandTBA，andnegat

7、ivelycorrelatedwithCHE(P<0．05)．ConclusionWeshouldpayattentiontotheexaminationofhistopatho1ogyofPBCdiagnosis．JudgementofthediseaseconditionandprognosiscanrefertotheindexesofTBil，TBA，CHE，andcomprehensivelyanalyzetheclinicalsymptoms，biochemicalindexes，autoantibodydetectionan

8、dhistologicalexamination．[Keywords]Primarybiliarycirrhosis；Clinicalmanifestation；Pathology原发性胆汁性