原发性胆汁性胆管炎患者血清学指标与病理分期的关系及原发性胆汁性胆管炎预后危险因素分析

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Abstract Objective To investigate the correlation between serological indicators and pathological staging in patients with primary biliary cholangitis(PBC)and prognostic factors of PBC.Methods Forty-six patients with PBC(PBC group)admitted to Nanchang Ninth Hospital,and 50 patients without liver disease(control group)were selected between April 2015 and October 2020.Serum total bilirubin(TBil),total bile acid(TBA),cholinesterase(CHE),alkaline phosphatase(ALP),γ-glutamyl transpeptidase(γ-GT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),globulin(GLB)and immunological indicators(anti-nuclear antibody[ANA],anti-mitochondrial antibody[AMA],anti-mitochondrial antibody M2[AMA-M2],anti-gp210 antibody[gp210],anti-sp100 antibody[sp100])in the two groups were detected,and the correlation between the above indexes and pathological stages were analyzed,and the risk factors affecting the prognosis of PBC were discussed.Results The levels of TBil,TBA,CHE,ALP,γ-GT,ALT,AST,ALB,and GLB in the PBC group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The levels of TBil,γ-GT and GLB in stage Ⅲwere higher than those in stage Ⅰ,and the differences were statistically significant(P＜0.05).The levels of ALP and AST in stage Ⅱand stage Ⅲwere higher than those in stage Ⅰ,and the differences were statistically significant(P＜0.05).The levels of CHE and ALB in stage Ⅱand stage Ⅲwere lower than those in stage Ⅰ,and the differences were statistically significant(P＜0.05).The level of ALP in stage Ⅲwas higher than that in stageⅡ,and the difference was statistically significant(P＜0.05).There were statistically significant differences in the positive detection rate of AMA-M2 among patients with PBC in different pathological stages(P＜0.05).Univariate analysis showed that age,TBil,γ-GT,and ALB were related to the prognosis of patients with PBC(P＜0.05).Multivariate analysis found that TBil(β=0.031, OR=1.031,95%CI=1.015-1.048)was an independent prognostic factor of patients with PBC,and ALB(β=0.182, OR=0.834,95%CI=0.756-0.919)was a protective factor of patients′ prognosis with PBC(P＜0.05).Conclusion The levels of TBil,TBA,CHE,ALP,γ-GT,ALT,AST,ALB and GLB,the positive detection rates of ANA,AMA,AMA-M2,and sp100 are different in patients with PBC in different pathological stages.TBil and ALB are factors influencing the prognosis of patients with PBC.Clinically,the detection of related serological indicators can assist in judging the pathological stage and prognosis,thereby providing a basis for treatment.

Key words： Primary biliary cholangitis Pathological staging Prognosis Risk factor

Received: 29 September 2021

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