| Objective:To explore the difference of in prognostic evaluation of different types of autoantibody matching in patients with primary cholangitis(Primary biliary cholangitis,PBC)and the risk factors that may affect the prognosis of PBC patients,in order to carry out early detection and prevention,and reduce the occurrence of adverse events of liver disease.Methods:1.From November 2010 to November 2021,190 patients were diagnosed with primary cholangitis.They were treated with ursodeoxycholic acid capsules(250mg;manufacturer:Losan+Pharma+GmbH)13-15mg/kg/d for more than one year.General date such as age,sex,smoking history,alcohol history,diabetes history and hypertension history were collected.Baseline ursodeoxycholic acid levels and the related biochemical and immunological indices were collected for more than 1 year.The ALBI score and the Globe 3-year non-liver transplantation survival score were calculated with the relevant biochemical indices one year later.2.According to the different types of antibodies,they were divided into antimitochondrial M2 antibody positive group(group A),anti-mitochondrial M2 antibody positive and anti-Sp100 antibody positive matching group(group B),antimitochondrial M2 antibody positive group was matched with anti-gp210 antibody positive group(group C).The prognostic differences between the three groups were analysed and compared in order to identify the antibody group with the worst prognosis among the three groups.3.According to the stage of liver cirrhosis diagnosed by PBC or the stage of liver cirrhosis with gastrointestinal bleeding,encephalopathy,liver cancer and other complications,the poor prognosis was defined as the high-risk group,and those who did not meet the above criteria were classified as the low-risk group.The general data and laboratory indices of the two groups were analysed and compared,and the differences were included in the multivariate analysis to further explore the risk factors affecting the prognosis of PBC patients,and the ROC curve was drawn.The clinical value of the factors in predicting prognosis was compared.Results:1.The prognosis of each group was significantly different in anti-mitochondrial M2 antibody positive group(group A),anti-mitochondrial M2 antibody positive and antisp100 antibody positive matching group(group B),anti-mitochondrial M2 antibody positive group was matched with anti-gp210 antibody positive group(group C)(P<0.001).The prognosis of group C was worse than that of group B,and the prognosis of group B was worse than that of group A(P<0.05).The prognosis of group C was significantly worse than that of group A(P<0.001).2.ALB,TBIL,platelet,erythrocyte count,haemoglobin,gp210 positive,GLOBE 3year non-liver transplantation survival score and ALBI score were different between high-risk group and low-risk group,which may affect the prognosis of patients.The overall average score of ALB,RBC count,platelet count and GLOBE 3-year nonliver transplant were lower in the high-risk group than in the low-risk group,and the overall level of total bilirubin was higher than that in the low-risk group.3.gp210、TBIL、ALB、platelets、ALBI score 2、ALBI score 3、GLOBE 3year non-liver transplantation survival score is an independent risk factor for the prognosis of PBC.The OR values are respectively 1.223、0.989、0.896、0.943、8.171、1.223、0.16,P values are 0.014、>0.05、0.043、<0.001、0.07、0.014、0.045,respectively。4.Platelet is the best predictor of PBC prognosis,followed by GLOBE 3-year nonliver transplantation survival score,ALB,gp210,and finally ALBI score,AUC value is respectively 0.873、0.761、0.746、0.702、0.646,The sensitivities of the above indices in predicting the prognosis of patients with PBC are 0.8611、0.7361、0.6944、0.6111、0.9861,The specificities are respectively 0.7797、0.7288、0.6695、0.7203、0.1695。Conclusion1.Among the three groups of antibody matching combinations,the prognosis of patients with M2 antibody and gp210 antibody matching was the worst,showing that there are differences in the prognosis of PBC patients with different antibody matching,which provides a theoretical basis for early detection and timely prevention of adverse liver events in patients with different PBC antibody matching.2.ALB,platelets,gp210 positive,ALBI score and GLOBE 3-year non-liver transplantation survival score are independent risk factors that influence the prognosis of PBC.The higher the ALBI score,the more reliable it is.By comparing the above biochemical indices,ALBI score and GLOBE score,it provides a theoretical basis for predicting prognosis and clinical treatment effect.3.Platelets are the best at predicting the prognosis of patients with PBC.For patients with PBC,dynamic monitoring of platelets has good clinical value in predicting the prognosis of patients with PBC. |
PDF Full Text Request