Observation Of Curative Efficacy On Primary Biliary Cirrhosis With Characteristics Hepatitis

BackgroundAutoimmune liver disease(AILD)is a group of diseases caused by the dysfunction of liver cells and bile duct epithelial cells.The most common are three categories,respectively for autoimmune hepatitis(AIH),primary biliary cirrhosis(PBC),primary sclerosing cholangitis(PSC).In addition,some patients may have at the same time or have two or more than two kinds of autoimmune liver disease overlap,known as overlap syndrome(OS).Among them,the most common is AIH-PBC OS,its diagnostic criteria and treatment has been more research.Recently,we found that a small number of patients with PBC may be associated with AIH characteristics,but at the same time can not reach the 1999 update of the AIH integration system and the diagnostic requirements of the Paris standard,the diagnosis of these patients is between PBC and AIH-PBC OS,known as PBC with AIH features.The diagnosis and treatment of no related reports,whether in ursodeoxycholic acid(UDCA)on the basis of positive and suppressive therapy still need in-depth exploration by immune.In this paper,we retrospectively analyzed the clinical results of 31 cases of PBC combined with AIH in combination with UDCA and glucocorticoid in order to obtain a more active treatment.ObjectiveResearch and discussion of UDCA combined with glucocorticoid for the treatment of PBC with AIH characteristics of biochemical indexes,immunological indexes,liver pathology and immunosuppressive therapy effect.MethodsPatients with PBC with AIH characteristics,who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2014 and June 2016,were enrolled in this study.According to the different treatment programs,the statistical objects were divided into UDCA group and UDCA combined with glucocorticoid,According to the pathological inflammation of chronic hepatitis(G),the degree of fibrosis(S)can be divided into two groups,the degree of inflammation or less G2,the degree of fibrosis S2 for pathology or less early group,the degree of inflammation > G2 > S2 for pathological late group,the degree of fibrosis.The data of blood biochemical indexes,immunological indexes,liver histopathology and response were collected before and after treatment,analysis by SPSS statistical software.Results1.Before and after treatment in the two groups in age,gender,biochemical indexes,immune indexes,there was no significant difference in liver elasticity,the results of AIH(P> 0.05).2.The GGT,ALP and IgM in the monotherapy group decreased compared with that before treatment,and the improvement of ALP and IgM was statistically significant(P<0.05).TheALT,AST,GGT,ALP,GLOB,IgG,IgM,C3 and C4 in the combined treatment group were lower than those before treatment,the levels of ALT,AST,GLOB,IgG,C3andC4 were lower than those of the single drug group,and the difference was statistically significant(P<0.05).3.There was no significant difference in ALT,IgG and ALP in the biochemical and immune response rate of the treatment group(P> 0.05),but the response rate was better in the combined treatment group.The response rate of ALT in patients with different pathological stages was statistically significant(P<0.05).4.The degree of liver inflammation,fibrosis and duct injury in the combined treatment group were better than those before treatment.ConclusionUDCA combined with glucocorticoid in the treatment of patients with PBC with AIH characteristics,serum biochemical,immunological and histopathological indexes were significantly improved compared with the UDCA group.in the early stage of the treatment effect is better,it is recommended on the basis of UDCA positive use of immunosuppressive therapy,better control of disease progression.