| Purpose:To analyze the clinical characteristics and disease progression of patients with primary biliary cholangitis(PBC)who were positive for different immune indexes of AMA/AMA-M2 and gp210/sp100,so as to provide reference for clinicians to diagnose and treat the disease.Method:271 inpatients diagnosed with PBC admitted to the First Affiliated Hospital of Shanxi Medical University from January 2016 to December 2021 were collected.All patients were treated with UDCA orally at the dosage of 13-15mg/(kg·d).According to the autoantibody,patients were divided into group A([AMA/AMA-M2]~+[gp210/sp100]~-),group B([AMA/AMA-M2]~-[gp210/sp100]~+),and group C([AMA/AMA-M2]~+[gp210/sp100]~+).The general condition,liver function index,immune index,UDCA response,disease progression and other information of patients were collected for statistical analysis.Results:1.Among 271 patients with PBC in this study,there were 50 males(18.45%)and 221females(81.55%),with an incidence ratio of 1:4.42 and an average age of 60.53 years.There were 167 patients in group A(61.62%),31 patients in Group B(11.44%),and 73patients in group C(26.94%).There were no statistical differences in gender and age among the three groups.2.The incidence of jaundice in group B was significantly higher than that in group A,the incidence of abdominal distention in group C was significantly higher than that in group A,and the incidence of pruritus in group C was significantly higher than that in group B,P<0.05,and the difference was statistically significant.Other clinical symptoms were not statistically significant in each group.3.The incidence of cirrhosis and portal hypertension in group A was higher than that in group B,the incidence of splenomegaly in group C was higher than that in group A,and the incidence of ascites in group C was higher than that in group B,P<0.05,and the difference was statistically significant.In terms of other clinical adverse events,there was no statistically significant difference between the groups.4.Group B CHOL,LDL was higher than group A,group C of ALT,AST,ALP,GGT,GLB,TBIL,DBIL,ESR,RDW level higher than that of group A,propagated level lower than that of group A,group C propagated level lower than that of group B,and GLB level higher than that of group B,P<0.05,the difference was statistically significant.Other biochemical indexes were not statistically significant.5.IgA in group A was higher than that in group B(P<0.05),the difference was statistically significant,and the other immune indexes were not statistically significant.The positive rate of ANA in group A was higher than that in group B and C,and the positive rate of ANA in group C was higher than that in group B(P<0.05),and the difference was statistically significant.Other autoantibody indexes were not statistically significant.6.The UDCA complete response rate of group A was higher than that of group B(P<0.05),the difference was statistically significant,while the response rate of other groups was not statistically significant.7.The disease progression of PBC patients in each group was analyzed.The incidence of cirrhosis in the first,third and fifth years was as follows:Group A was 10.0%,22.0%and 44.7%,group B was 6.5%,12.9%and 25.8%,group C was 13.7%,24.7%and 54.8%,P=0.042;Further pairwise comparison showed that P=0.321,0.372,0.051,and there was no statistical significance in group A,B,and C.Conclusion:(1)PBC patients with positive AMA/AMA-M2 and/or gp210/sp100 were more likely to occur in middle-aged and elderly women.(2)The clinical manifestations and degree of liver damage in patients with PBC double positive for AMA/AMA-M2 and gp210/sp100were more serious than those with single positive.(3)In PBC patients with AMA/AMA-M2 positive,ANA antibody titers were higher than those with AMA/AMA-M2negative PBC,regardless of gp210/sp100 positive,and IgA levels were higher in PBC patients with both AMA/AMA-M2 and gp210/sp100 positive PBC.(4)The biochemical response rate to UDCA in gp210/sp100 positive PBC patients was lower than that in anti-GP210/sp100 negative patients.(5)The progression of liver cirrhosis may be faster in PBC patients with double positive AMA/AMA-M2 and gp210/sp100 compared with patients with single positive gp210/sp100. |
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