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目的探讨原发性胆汁性肝硬化(PBC)患者肝功能及血清免疫学特征并对其相关性进行分析。方法回顾性分析河南省人民医院90例PBC住院患者资料,另选取同期健康体检者120例为对照组,2组对象进行比较。结果与对照组相比,PBC组血清ALT、AST、TBIL、DBIL、IBIL、ALP、γ-GGT、GLO、RDW、Ig G、Ig M及Ig A明显升高,ALB、C3、C4明显降低,差异均有统计学意义(P<0.05);PBC组ALT与AST和γ-GGT呈正相关(P<0.05),AST与ALP、γ-GGT、TBIL、DBIL和IBIL呈正相关(P<0.05),GLO与Ig G和Ig A呈正相关(P<0.05),DBIL、IBIL与TBIL之间两两呈正相关(P<0.05),ALP与γ-GGT及C3与C4之间呈正相关(P<0.05),ALB与DBIL、IBIL和TBIL呈负相关(P<0.05)。结论PBC患者有明显的肝功能紊乱,多种肝功能指标间明显相关,PBC发生发展过程中有多种机制参与;PBC患者胆红素代谢异常尤为显著,与AST和ALB等指标间相关关系具有相对独立性,是疾病严重程度的关键指标;PBC组血清Ig A、Ig M和Ig G明显升高,C3、C4明显下降,体液免疫在其发生发展过程中有重要作用。
Objective To investigate the liver function and serum immunological characteristics of patients with primary biliary cirrhosis (PBC) and to analyze their correlation. Methods The data of 90 PBC hospitalized patients in Henan Provincial People’s Hospital were retrospectively analyzed. Another 120 healthy subjects were selected as the control group, and the subjects in the two groups were compared. Results The levels of ALT, AST, TBIL, DBIL, IBIL, ALP, γ-GGT, GLO, RDW, Ig G, Ig M and Ig A in PBC group were significantly higher than those in control group (P <0.05). ALT was positively correlated with AST and γ-GGT in PBC group (P <0.05), AST was positively correlated with ALP, γ-GGT, TBIL, DBIL and IBIL (P < There was a positive correlation between GLO and Ig G and IgA (P <0.05), positive correlation between DBIL, IBIL and TBIL (P <0.05), ALP and γ-GGT and C3 and C4 (P <0.05) , ALB was negatively correlated with DBIL, IBIL and TBIL (P <0.05). Conclusions There are obvious liver dysfunction in PBC patients, and there is a significant correlation between various indexes of liver function. There are many mechanisms involved in the development and progression of PBC. The abnormalities of bilirubin metabolism in PBC patients are particularly significant. The correlations with AST and ALB indexes Relative independence was the key indicator of disease severity. Serum Ig A, Ig M and Ig G in PBC group were significantly increased, while C3 and C4 were significantly decreased. Humoral immunity played an important role in its development.