Clinical Analysis Of 266 Cases Of Primary Biliary Cholangitis

PurposeBy analyzing the clinical data of 266 patients with primary biliary cholangitis,the clinical characteristics,disease severity and treatment response of different course groups were compared.MethodsGeneral information,clinical manifestations,serum biochemical indexes,imaging examination,UDCA dosage and response of patients with primary biliary cholangitis(PBC)first diagnosed in China-Japan Union Hospital of Jilin University from January 2010 to December 2018 were collected,and clinical characteristics,disease severity and treatment response characteristics were analyzed.ResultsA total of 266 patients with PBC were included in this study,including 108 patients(40.6%)whose medical history was <1 year,and 158 patients(59.4%)whose medical history was ?1 year.The ratio of male to female is 1:7.9.Patients with medical history < 1 year had AST and ALT of 67.0IU/L and 66.0IU/L,respectively,which were significantly higher than those with medical history ?1 year(P <0.05).Patients with medical history < 1 year had ApoA1 and ApoB levels of 1.01g/L and 0.93g/L,respectively,which were significantly lower than those with medical history ?1 year,and P < 0.05.The proportion of patients who had developed cirrhosis at the time of presentation was 77.8%,and that of Child pugh grade B/C was 53.0%.Complicated with immune disease rate was 10.9%.The positive rate of AMA-M2 was 94.7%.In patients with medical history <1 year,the proportion of decompensated patients was the highest(46.9%),while in patients with medical history ?1 year,the proportion of symptomatic patients is the highest(76.1%).There was a significant difference between the two groups(P<0.001).Among patients with medical history of <1 year,the proportion of patients in the low-risk group was 19.8%,which was lower than that in patients with medical history of ?1 year.Patients with medical history < 1 year accounted for 33.3% of the patients at medium risk,which was higher than those with medical history ?1 year.For patients with medical history <1 year or ?1 year,the response rate of 13-15mg/(kg.d)UDCA patients after 1 year was significantly higher than those with medical history <13mg/(kg.d)and > 15mg/(kg.d)UDCA patients,P < 0.05.Among the 200 patients with PBC who underwent histopathological examination,the proportion of phase III patients was the highest among the patients with medical history less than 1 year and ?1 year,which was significantly higher than that of the other three patients(all P < 0.05).The proportion of phase II patients with medical history < 1 year was 34.1%,significantly higher than that of patients with medical history ?1 year(13.4%),P < 0.05.Conclusions1.There were gender differences in the incidence,history composition and degree of liver inflammation in PBC patients.2.Most patients with PBC were treated for clinical symptoms,and the incidence of cirrhosis was as high as 77.8% at the time of diagnosis,among which 53.0% were in decompensated cirrhosis.3.The severity of the disease was not exacerbated by the extension of the medical history.Among the patients with medical history <1 year,the proportion of patients with clinical stage of decompensation was the highest;among the patients with medical history <1 year and ?1 year,the proportion of patients with high risk of disease was similar and the proportion of patients with histopathology in stage III was the highest.4.Patients with 13-15 mg/(kg.d)UDCA had the highest response rate after 1 year,regardless of the patient's medical history of < 1 year or ?1 year.