Clinical Analysis Of Primary Biliary Cholangitis:A Report Of 44 Cases

【Objective】To improve the level of awareness of the disease and treatment, reduce the misdiagnosis rate and improve patients prognosis by analyzing the clinical characteristics and treatment outcome of PBC.【Methods】From January 2010 to December 2015, 44 patients hospitalized with PBC,Gastroenterology of Second Affiliated Hospital of Soochow University were reviewed,including general status, clinical manifestation, serum biochemical indices,immunological indicators, imageological examination and treatment outcome.【Results】Among 44 patients, 37 were females(84.1%), 7 were males(15.9%), the mean age was(59.66±10.90) years old. Mean time from the onset of symptomsor liver function change to diagnosis was 8.13 months,the longest was 48 months. The major symptoms in these patients were abdominal distension(11/44,25.00%), fatigue(10/44,22.73%),anorexia(9/44,20.45%) and jaundice(13/44,29.55%); the major signs included splenomegaly(14/44,31.82%), hepatomegaly(6/44,13.64%) and ascite(10/44,22.73%).Serum alkaline phosphatase(ALP) and glutamyl transpeptidase(GGT) levels were markedly elevated in all the patients [GGT(389.64±296.11)U/L 、 ALP(388.09±225.99)U/L]. Whereas ALT and AST levels were mildly to moderately elevated[AST(140.11±128.32)U/L、ALT(138.39±178.95)U/L]. Mean level of direct bilirubin is(37.35±30.35)umol/L. Serum antimitochondrial antibodies(AMA) were positive in(88.64%) of patients,antinuclearantibodies(ANA) were positive in(95.45%) of patiens.Among patients who were seronegative of AMA\AMA-M2, anti-Sp100 were positive in20.0% and anti-gp210 were positive in 60.0%.【Conclusion】PBC mainly affects middle-aged women and the main clinical manifestation are fatigue, anorexia and jaundice,often accompanied by other autoimmune diseases and some patients are asymptomatic at eally stag.Positive serum AMA or AMA-M2 is the most prominent immunologicalindexes in the diagnosis of PBC. UDCA is the only drug which is effective and now it is the first line therapeutic drug of PBC.The late stage of the patients have poor prognosis SO that Early detection and treatment may retard the progressive ofthe disease and improve the prognosis.