抗线粒体抗体-M2阳性体检人群与原发性胆汁性肝硬化患者相关临床特征横断面比较

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目的:比较抗线粒体抗体-M2(AMA-M2)阳性体检人群与住院患者临床特点,探讨两组人群与原发性胆汁性肝硬化(PBC)相关的临床症状及实验室检测指标的关系,以加强对PBC的认识,提高早期确诊率。方法:收集2009年1月—2013年12月我院住院患者AMA-M2阳性病历669份,2010年2月—2012年10月间本地区常住人口健康体检AMA-M2阳性档案156份。组间差异比较采用2检验,<0.01为差异有统计学意义。结果:两人群血常规异常率(62.78%46.15%)肝功能异常率(57.1%42.31%)总体比较差异较大,有统计学意义;但具有诊断价值的ALP、GGT两个酶类差异较小,无统计学意义;两人群早期临床症状如腹部不适、疲倦乏力、贫血等发生率差异也无统计学意义;两组人群胆囊病史、糖尿病病史、过敏史发生率均较高,但差异不显著,无统计学意义;就诊组晚期症状黄疸及早期症状发作频率和程度明显高于体检组,差异有统计学意义。就诊组男女比例明显高于体检组(1:2.14 1:3.88)差异有统计学意义。结论:通过两组人群比较显示AMA-M2阳性做为PBC特异性指标具有早期诊断价值,揭示PBC存在持续性加重的发生发展过程。对于实验室检测血常规异常、肝功异常,主诉消化不良、疲劳乏力等人群及早行AMA-M2等自身抗体的检测,有利于PBC的早期确诊。 OBJECTIVE: To compare the clinical features of AMA-M2-positive patients with inpatients and to explore the relationship between the clinical symptoms and laboratory tests in patients with primary biliary cirrhosis (PBC) Strengthen the understanding of PBC and improve the early diagnosis rate. Methods: From January 2009 to December 2013, 669 AMA-M2 positive cases were collected from inpatients in our hospital and 156 positive AMA-M2 files were obtained from February 2010 to October 2012 in our hospital. Differences between groups using 2 test, <0.01 for the difference was statistically significant. Results: The prevalence of abnormal liver function (62.78%, 46.15%) was significantly different between the two groups (57.1%, 42.31%), but there was a small difference between the two enzymes of ALP and GGT , No statistical significance; two groups of early clinical symptoms such as abdominal discomfort, fatigue, anemia and other differences were not statistically significant; two groups of people with a history of gallbladder disease, diabetes history, the incidence of allergies were high, but the difference was not significant , There was no statistical significance; the frequency and degree of symptoms of jaundice and early symptoms in the treatment group was significantly higher than that of the physical examination group, the difference was statistically significant. The ratio of male to female in the treatment group was significantly higher than that in the physical examination group (1: 2.14 1: 3.88). Conclusion: Comparison of two groups of patients shows that AMA-M2 positivity has early diagnostic value as a specific indicator of PBC, revealing the occurrence and development of PBC. Detection of abnormal blood tests in the laboratory, abnormal liver function, complaints of dyspepsia, fatigue, fatigue and other early detection of AMA-M2 and other autoantibodies, is conducive to the early diagnosis of PBC.
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