Analysis Of The Clinical Characteristics Of Patients With Primary Biliary Cholangitis And The Influencing Factors Of UDCA Response Rate

Research objectives:By analyzing the clinical data of 381 patients with primary bile cholangitis,the clinical characteristics of patients with primary bile cholangitis and the influencing factors of UDCA response rate were studied.Research Methods:The general characteristics,clinical manifestations,immunology,clinical staging,pathological staging and treatment of patients with primary cholangitis diagnosed in China-Japan Union Hospital of Jilin University from January 2010 to January 2019 with complete medical records were retrospectively analyzed.Results:1.A total of 381 cases of PBC were included in this study,including 50 male patients and 331 female patients,with a male-female ratio of 1:6.62.The age range of the patients was 20-89 years old at the time of diagnosis,with an average age of 56.54±11.96 years.2.The levels of glutamine transferase(GGT),alkaline phosphatase(ALP)and total bilirubin(TBIL)of PBC patients in the elderly group were all lower than those in the non-elderly group(P<0.05).However,the proportion of PBC patients in the elderly group who had fatigue symptoms(76.7%),cirrhosis(45.6%)and extrahepatic diseases(81.6%)was significantly higher than that in the non-elderly group(P < 0.05).3.The levels of ALP,GGT and TBIL in patients with pruritus were higher than those in patients without pruritus(all P <0.05).The proportion of patients with pruritus in jaundice/hepatic failure was 22.01%,higher than that of patients without pruritus(8.11%),all P <0.05.4.The ALP level of patients with AMA-M2(+)was higher than that of patients with AMA-M2(-).In patients with AMA-M2(+),the ALP and TBIL levels of anti-gp210 or anti-sp100(+)patients were significantly higher than those of anti-sp100 and anti-gp210(-)patients,all P < 0.05.In patients with AMA-M2(-),the TBIL level of patients with anti-gp210 or anti-sp100(+)was significantly higher than that of patients with anti-gp210 and anti-sp100(-),P<0.05.The proportion of jaundice/liver failure in anti-gp210 or anti-sp100(+)patients was significantly higher than that in anti-gp210 and anti-sp100(-)patients,whether in AMA-M2(+)or AMA-M2(-)patients.5.The differences in ALP and TBIL levels between different PBC pathological grades were statistically significant(all P <0.05).The proportion of patients with grade 3-4 in the clinical stage who were in the symptomatic stage and decompensated stage was 92.31%,which was significantly higher than that of patients with grade 1-2 in the clinical stage(61.76%).The proportion of jaundice/hepatic failure and portal hypertension in grade 3-4 patients was significantly higher than that in grade 1-2 patients(all P <0.05).6.Analysis of UDCA response rate and influencing factors in PBC patients: the 1-year UDCA response rate of patients <45 years old was 44.19%,lower than that of patients aged 45-64 years old(60.63%)and ≥65 years old(75.00%),all P <0.05.The factors affecting UDCA response rate were further analyzed.Age,gender,presence of pruritus,positive immunological index,liver function index(ALP,TBIL)and clinical stage were included in the multi-factor analysis.The results suggested that age,clinical stage and TBIL level were risk factors affecting UDCA response rate.Conclusion:1.The degree of liver inflammation in elderly patients is less than that in non-elderly patients,but the degree of disease severity is more serious than that in non-elderly patients.2.High rates of jaundice/liver failure in patients with prurgitation and anti-sp100 or anti-gp210(+).3.The proportion of patients with ama-m2(+)in the symptomatic stage and decompensated stage was higher than that of patients with ama-m2(-).4.Age,clinical stage and TBIL level were risk factors affecting the 1-year response rate of UDCA.