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目的探讨失代偿期合并腹水的PBC患者临床特征及其实验检查的特点。方法分析66例肝功能失代偿期合并腹水的PBC患者,分析入院时(治疗前)临床症状及血常规、肝功、肾功、血脂、凝血酶原活动度(PA)、腹水化验等指标。结果66例PBC中女性61例(92.4%),平均(53.7±9.9)岁。最常见的临床症状依次为腹胀(90.9%)、乏力(87.8%)、食欲减退(62.1%)、皮肤瘙痒(34.8%)。最常见的体征为黄疸(75.8%)、脾大(68.2%)、肝大(57.8%)。对ChildPugh计数分级法为A和B级的34例与C级的32例患者的实验室指标进行成组t检验,两组患者ALT、AST、GLO、TC、TG、ALP、GGT、HB、PLT等指标差异无显著性(P>0.05)。结论失代偿期PBC患者仍以中年女性多见,以腹胀、乏力、食欲减退、瘙痒、黄疸、肝脾肿大为主要临床表现。肝功能异常以胆汁淤积为主,伴有ALP、GGT显著增高,抗线粒体抗体(AMA/M2)阳性。以熊去氧胆酸(UD-CA)为主的治疗可以取得一定的疗效。
Objective To investigate the clinical features of PBC patients with decompensated ascites and its characteristics of laboratory tests. Methods Sixty-six patients with PBC who had decompensated liver dysplasia and ascites were analyzed. The clinical symptoms, blood test, liver function, renal function, blood lipids, prothrombin activity (PA) . Results Sixty-six cases (92.4%) of 66 PBC patients were found, with an average of (53.7 ± 9.9) years. The most common clinical symptoms were bloating (90.9%), fatigue (87.8%), loss of appetite (62.1%) and pruritus (34.8%). The most common signs were jaundice (75.8%), splenomegaly (68.2%) and hepatomegaly (57.8%). The level of ALT, AST, GLO, TC, TG, ALP, GGT, HB, PLT in the two groups were analyzed by using the t-test in 34 children with grade A and grade B and 32 patients with grade C in Child Pugh classification test. No significant difference (P> 0.05). Conclusion The decompensated PBC patients are still more common in middle-aged women, abdominal distension, fatigue, loss of appetite, itching, jaundice, hepatosplenomegaly as the main clinical manifestations. Liver dysfunction mainly cholestasis, accompanied by ALP, GGT was significantly higher, anti-mitochondrial antibodies (AMA / M2) positive. Ursodeoxycholic acid (UD-CA) -based treatment can achieve some effect.