| Objectives: to observe the features of positive signs and symptoms, serologicalindicator, Immunological indicators, liver biopsy results, therapeutic outcome in PBC.Methods：Choosing194PBC in patients were grouped，whose general conditions，Positive performance，serological examination，immunologic test，and pathologicalalteration were assessed. And evaluate the bear to ursodeoxycholic Acid (UDCA) inpatients with PBC positive performance, serological examination, immunologicaltests, the influence of adverse events and other indicators. Results：The first part ofthis paper, data show that:1) the study of January2008-April2013in our hospitalmeet the following diagnostic criteria for primary biliary cirrhosis194patients,including19males, female175cases, with an average age of was56.46±11.15years old.2) The group of194cases of primary biliary cirrhosis in129cases(66.5%) jaundice,133cases (68.6%) were fatigue, loss of appetite symptoms, thepresence of skin itching121cases (62.4%) patients,72cases (37.1%) occurred inpatients with abdominal pain,36cases (18.6%) patients with steatorrhea,23cases(11.8%) patients with gastrointestinal bleeding,36cases (18.6%) patients with dryeyes, dry mouth phenomenon,24patients (12.4%) patients with joint pain;48cases (24.7%) patients with liver palms and spider veins,98cases (50.5%)patients had hepatosplenomegaly,50cases (25.8%) patients with varicose veins,59cases (30.4%) patients with ascites,50cases (25.8%) patients with lower limbedema,24cases (12.4%) patients had xanthomas.3)36cases (18.6%) patientswith lung or biliary tract infection,72cases (37.1%) patients with electrolytedisorders,24cases (12.4%) patients with concurrent acid-base imbalance,22cases(11.3%) patients with concurrent liver encephalopathy,21cases (10.8%) patientswith spontaneous bacterial peritonitis.4)12cases (6.2%) patients with Sjogren’ssyndrome,12cases (6.2%) patients with rheumatoid arthritis,11cases (5.7%)patients with Hashimoto’s thyroiditis,8cases (4.1%) patients with rheumatoid arthritis, eight cases (4.1%) patients with concomitant rheumatoid arthritis,Sjogren’s syndrome.5) The group of patients with primary biliary cirrhosis ALP,ALT, AST, GGT was325.6±259.0IU/L,92.7±24.51IU/L,102.6±58.23IU/L,271.8±105.9IU/L, were significantly higher than the normal reference range (0-40IU/L) ALP and GGT especially the most obvious; this group of patients TBil, DBillevel was191.5±126.4umol/L and95.6±77.1umol/L, were significantly higherthan normal reference range (TBil:1.7-17.1umol/L; DBil:0-3.4umol/L),especially the most obvious TBil rise.6) We examined the immune three IgA, IgM,IgG levels were6.5±6.3mg/L,17.3±2.5mg/L and28.2±11.9g/L,significantly higher than the normal reference range (IgA:0.69-3.82mg/L;IgM:0.63-2.77mg/L; IgG:7.23-16.85g/L), especially IgM significantly. Wealso observed several other immune parameters, the survey results show that thehighest rate of anti-M2antibody positive (89.7%), followed by anti-ANA antibodyfollowed by (32.5%), Sp100(20.5%), Gp210(30.7%), Ro52(35.9%) or less, areless than40%.7) The group of194cases with primary biliary cirrhosis,45routineliver biopsy, in which48.9%of patients in the Phase I (cholangitis),28.9%ofpatients in Phase II (small bile duct hyperplasia period),13.3%patients in stage III(scar stage),8.9%of patients in stage IV (hardening period).The second part of the data displayed in this article:1) before the treatment,each group the positive signs and symptoms of percentage had no significantdifference (P>0.05).Improved after treatment, the treatment group were better thancontrol group (P <0.05), while the improved except fatigue, loss of appetite, andliver palm, ZhiZhuZhi, xanthoma phenomenon.Serological indexes of thecomparison results for2), before the treatment, no significant differences betweengroups the serological indexes (P>0.05).After treatment, the treatment group ALP,ALT, AST, GGT, TBil, DBil value were reduced to109.7+/-237.8,52.5+/-51.5,51.5,113.9+/-272.3,272.356.1mm+/-72.5,37.646.3mm.ALP and the controlgroup, ALT, AST, GGT, TBil, DBil value were reduced to222.7+/-198.6,75.8+/-63.4,63.4,225.1+/-286.7,286.760.9mm+/-73.2,75.233.1mm.The serological indexes after treatment, the treatment group were lower than control group (P <0.05).3) our immunological indexes comparison shows that before the treatment,each group had no significant difference (P>0.05).After treatment, the three groupsof immune and AMA-M2positive resistance, Sp100positive rate, Gp210positiverate had no significant difference (P>0.05).And after treatment, the treatment groupthe ANA positive rate fell to9%, significantly lower than control group (P <0.05).4)treatment group (11cases (10.1%) appeared diarrhea,7cases (10%) and controlgroup in diarrhea, diarrhea occurrence rate is higher than the control group, treatmentgroup but disappear after dose reduction, namely.In addition, we also observed theother adverse events happening, found that each group had no case of joint pain andrespiratory symptoms;Treatment group has3cases (4%), abdominal pain, abdominalpain in2cases (4%) and control group.Treatment group3cases (4%) havepalpitations,2cases (4%) and control group have palpitations;Treatment group2(3%) patients appeared dizziness, headache,2cases (4%) and control group appeardizziness have a headache.5) according to survival observation, the study on average(37.4+18.73) months follow-up, the treatment group of68cases of patients withPBC, the first year without1case progress for stage IV (hardening period), thesecond year in2cases (3%) progress for stage IV (hardening period);In the secondyear of first year1case death,2cases died (3%);No change in the first year0cases(0%), the second year of0cases (0%).Control group of53cases of PBC patients,2cases (4%) in the first year progress for stage IV (hardening period), the second yearof progress in7cases (13%) for stage IV (hardening period);2cases died (4%) in thefirst year to the second year in6cases (11%) died;No change in the first year in3patients (6%), the second year for5cases (9%).1) before the treatment, each groupthe positive signs and symptoms of percentage had no significant difference (P>0.05).Improved after treatment, the treatment group were better than control group (P<0.05), while the improved except fatigue, loss of appetite, and liver palm,ZhiZhuZhi, xanthoma phenomenon.Serological indexes of the comparison results for2), before the treatment, no significant differences between groups the serological indexes (P>0.05).After treatment, the treatment group ALP, ALT, AST, GGT, TBil,DBil value were reduced to109.7+/-237.8,52.5+/-51.5,51.5,113.9+/-272.3,272.356.1mm+/-72.5,37.646.3mm.ALP and the control group, ALT, AST, GGT,TBil, DBil value were reduced to222.7+/-198.6,75.8+/-63.4,63.4,225.1+/-286.7,286.760.9mm+/-73.2,75.233.1mm.The serological indexes aftertreatment, the treatment group were lower than control group (P <0.05).3) ourimmunological indexes comparison shows that before the treatment, each group hadno significant difference (P>0.05).After treatment, the three groups of immune andAMA-M2positive resistance, Sp100positive rate, Gp210positive rate had nosignificant difference (P>0.05).And after treatment, the treatment group the ANApositive rate fell to9%, significantly lower than control group (P <0.05).4) treatmentgroup (11cases (10.1%) appeared diarrhea,7cases (10%) and control group indiarrhea, diarrhea occurrence rate is higher than the control group, treatment groupbut disappear after dose reduction, namely.In addition, we also observed the otheradverse events happening, found that each group had no case of joint pain andrespiratory symptoms;Treatment group has3cases (4%), abdominal pain, abdominalpain in2cases (4%) and control group.Treatment group3cases (4%) havepalpitations,2cases (4%) and control group have palpitations;Treatment group2(3%) patients appeared dizziness, headache,2cases (4%) and control group appeardizziness have a headache.5) according to survival observation, the study on average(37.4+18.73) months follow-up, the treatment group of68cases of patients withPBC, the first year without1case progress for stage IV (hardening period), thesecond year in2cases (3%) progress for stage IV (hardening period);In the secondyear of first year1case death,2cases died (3%);No change in the first year0cases(0%), the second year of0cases (0%).Control group of53cases of PBC patients,2cases (4%) in the first year progress for stage IV (hardening period), the second yearof progress in7cases (13%) for stage IV (hardening period);2cases died (4%) in thefirst year to the second year in6cases (11%) died;No change in the first year in3patients (6%), the second year for5cases (9%). Conclusion:(1) common yellow gangrene of primary biliary cirrhosis,exhaustion, painful itch, hepatosplenomegaly, serum ALP, GGT and IgM increasedobviously, the M2and higher positive rate of ANA present.(2) liver biopsy fordiagnosis and histological staging of primary biliary cirrhosis.(3) bears to oxygencholic acid can significantly improve the patients of primary biliary cirrhosis,serology, immunology, and no significant adverse events. |
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