不同组织学分期原发性胆汁性肝硬化患者临床特征分析-论文.pdf

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1、·442·实用肝脏病杂志2013年10月第16卷第5期JClinHepatol，Oct．2013．Vo1．16No．5·肝硬化·不同组织学分期原发性胆汁性肝硬化患者临床特征分析孙颖滕光菊常彬霞张伟赵军邹正升李保森【摘要】目的比较不同组织学分期原发性胆汁性肝硬化(PBC)患者的临床特征。方法回顾性分析39例组织学分期为早期和55例为进展期的PBC患者的人口学、实验室检查、影像学检查和预后指标(Mayo风险评分、MELD评分、Child—Pugh评分)，比较两组患者之间的差异。结果早期与进展期患者年龄构成比无显著性差异，但均以4O～59岁居多

2、；两组患者平均年龄、ALB、CHE、TBIL、PT、P、TC、IgG、MRS、MELD评分、Child—Pugh评分均具有显著性差异；腹水、食道或胃底静脉曲张发生率亦具有显著性差异(P<0．05)；在早期患者仍可出现门脉高压的表现，出现腹水及食道静脉曲张的比例为7．7％；早期与进展期PBC患者乏力和瘙痒的发生率在两者之间无显著性差异(O．05)；病理分期与MRS、MELD及Child—Pugh评分均具有相关性。结论早期PBC患者的预后优于进展期患者，但在PBC早期仍可出现门脉高压的表现，临床医生应予以重视。【关键词】原发性胆汁性肝硬化；组

3、织学分期；临床特征doi：10．3969~．issn．1672-5069．2013．05．019AnalysisoftheclinicalfeaturesofpatientswidlprimarybiliarycirrhosisatdiferentfiverhistologicalstagesSunYing，凡gGuandu，ChangBinxia，eta1．DepartmentofNon-infectiousDiseases，302ndHospital，Bei-jg100039，China【Abstract】objec~veTocomp

4、aretheclinicalfeaturesofpatientswithprimarybiliarycirrhosis(PBC)atdif-ferentliverhistologicalstages．MethodsTheclinicalcharacteristicsof39patientswithPBCatearlyliverhisto-logicalstages，and55patientswithadvancedstageofPBCwereretrospectivelyanalyzed，andthedifferencesinde-mog

5、raphics，laboratorytests，imagingchecking-upandprognosticindicators(Mayoriskscores，MELD，Child-Pughscores)betweenthetwogroupswerecompared．ResultsThepercentagesofagebetweentheearlyandadvancedstageswerenotstatisticallysignificant，andthemajorityofpatientsinbothgroupswere40to59y

6、earsold；Therewerestatisticallysignificantdifferencesinmeanage，ALB，CHE，TBIL，PT，PLT，TC，IgG，MRS，MELDandChild—Pughscoresbetweenthetwogroups(P<0．05)；Theincidencesofascitesandesophagealorgastricvaricesbetweenthetwogroupswerestatisticallysignificant(P<0．05)；However，therewerestil

7、l7．7％PBCpatientsatearlyhistologi—calstagesofliverdevelopedascitesandesophagealorgastricvarices；ThehistologicalstagesweresignificantlyassociatedwiththeMRS，MELDandChild—Pughscores(P<0．05)．ConclusionAlthoughpatientswithPBCatear—lyliverhistologicalstagemayhaveabetterprognosis

8、thanpatientsatadvancedstages，theymayalsohaveportalhypertensionandclinicianshouldtakethisintocons