Analysis Of Influencing Factors For The Efficacy Of Ursodeoxycholic Acid In Patients With Primary Biliary Cholangitis

Objective:The clinical data of patients with PBC in refractory group and typical group at the time of initial treatment were compared to explore the influencing factors of efficacy.Method:Patients diagnosed with primary biliary cholangitis from the inpatient department and outpatient department of the First Hospital of Jilin University from January 2012 to December 2018 were collected.204 patients were selected as research objects according to the inclusion and exclusion criteria.All patients included were treated with ursodeoxycholic acid for more than one year.General clinical data(gender,age,symptoms,physical signs,etc.),complications and clinical stage,laboratory tests(biochemical,immunological parameters,etc.),imaging examinations(abdominal ultrasound / CT / MRI),liver histology examination at the time of initial treatment and liver function tests after 1 year of initial treatment.The research objects were divided into typical group and refractory group according to Paris-1 criterion.Compare the clinical data of the two groups at the time of initial treatment,and analyze the factors affecting the the response of UDCA.Result:1.204 patients with PBC were included in this study.Among them,29(14.2%)were male and 175(85.8%)were female.The male to female ratio was 1: 6.03,and the average age was 57.74 ± 12.09 years old.2.In the 204 PBC patients,118(57.8%)responded well and 86(42.2%)responded poorly.Analysis of factors influencing the efficacy of UDCA in the treatment of PBC: compared with typical PBC patients,univariate analysis suggested that refractory PBC had higher incidences of jaundice,splenomegaly,and ascites(P <0.05),clinical stage and pathological stage was later(P <0.05).At the same time,AST,ALT,GGT,ALP,TBIL,DBIL,NLR,and IgG levels were higher(P <0.05),while ALB,LY,and PLT levels were lower(P <0.05).In addition,the younger age(P = 0.061)may also be a potential influencing factor that lead to a worse recponse to UDCA in PBC patients,but the difference between the groups is not statistically significant.When the above variables were included in the binary logistic regression model,we found that the ALP level at the time of initial treatment(OR = 0.996;P = 0.002;95% CI: 0.993-0.999)was an independent influencing factor for the efficacy of UDCA in patients with PBC.Conclusion:Jaundice,splenomegaly,ascites,clinical stage,pathological stage,AST,ALT,GGT,ALP,TBIL,DBIL,NLR,IgG,ALB,LY,and PLT levels at the initial treatment were related to the efficacy of UDCA in patients with PBC,and ALP was an independent influencing factor for the efficacy of UDCA in the treatment of PBC.