Clinical Analysis Of 48 Cases With Primary Biliary Cirrhosis

Objectives:(1) To observe the features of clinic, biochemistry, immunology, pathology, treatment and prognosis in PBC.(2) To explore the relationship between serum biochemical items and liver function, AMA-M2 of PBC, so as to continue to improve understanding PBC.(3) To analyze and compare the clinical characteristics of PBC and SBC, in order to improve its diagnosis and treatment.Methods: Choosing 48 PBC inpatients were grouped, whose general conditions, clinical manifestations, biochemical and immunological changes, pathological features, treatment and prognosis were assessed. To analyze PBC according to AMA-M2 and liver function grouped, and choosing 70 SBC patients were involved as contrast.Results:(1) Among the 48 PBC patients, 36 cases were female and the mean age at diagnosis was 48.9±10.5 years. The period from occurrence to definite diagnosis was 2.2±2.4 years. Typical manifestations included jaundice, fatigue, pruritus, hepatosplenomegaly, ascites and lower limbs edema. Levels of ALP, GGT, IgM, TBil, DBil and BA were obviously elevated in PBC, and Levels of ALT and AST were elevated mildly to moderately. AMA-M2 is the specific antibody, and 75.0% patients were AMA-M2 positive. The results of biochemical indicator have no distinct differences between the AMA-M2 positive and the AMA-M2 negative. ALP and GGT were increased obviously in the early stage, then some decrease in the later stage, and TBil levels were elevated gradually along with the progression of PBC. Liver biopsy was available in 9 patients, 7 of them were positive, including 2 cases of PBC I, 3 of II, 1 of III, and lof IV. Pathological staging has something to do with clinical staging. In PBC patients who received therapy of UDCA, severity of PBC was alleviated in different degree.(2) Among the 70 SBC patients, 44 cases were female and the mean age at diagnosis was 42.5±14.8 years. 46 patients were caused by hepatic calculus, others such as congenital cyst of cholangiocarcinoma 15, congenital cholangiectasis 8, and biliary tract narrow after operation 1. ALP and GGT levels were elevated more obviously in SBC than PBC, other biochemistry characters were slightly changed. Imaging findings all showed biliary tracts abnormal. The operation has better curative effects than medical treatment in SBC.Conclution:(1) PBC main affects middle aged women. Jaundice, fatigue, pruritus, and hepatosplenomegaly, ALP, GGT and IgM levels increased, AMA-M2 positive are typical in diagnosis of PBC.(2) PBC biochemical changes don't concern AMA-M2. ALP and GGT are increased obviously in the early stage, and TBil levels are elevated gradually along with the progression of PBC.(3) Liver biopsy can help make an identify diagnosis and carry on pathological staging of PBC. Pathological staging has something to do with clinical staging. UDCA can improve curative effects of PBC.(4) SBC has no sex difference, and the age has some connection with primary affections, most of which are hepatic calculus. The positive rates of autoantibodies are extremely low, and Imaging findings all show biliary tracts abnormal. The major treatments are surgical therapies of primary affections.