Correlation Analysis Of Clinical Features,prognosis And Quality Of Life In Patients With Primary Biliary Cirrhosis

Objective: By summarizing the typical clinical characteristics,follow-up prognosis,and quality of life of the patients with primary biliary cholangitis(PBC)hospitalized in the Affiliated Hospital of Yan ’an University,we further deepened the clinical doctors’ cognition of PBC,early diagnosis and early treatment,and delay disease progression.Methods: Affiliated Hospital of Yan ’an University were retrospectively analyzed between December 2018 and December 2020 hospitalized PBC patients generally information(name,gender,age,weight,etc.)and serological data(routine blood,liver,kidney function,electrolyte,blood fat,blood clotting,etc.)and imaging data(abdominal ultrasound,CT,MRI and MRCP,etc.).The above data were statistically described and the clinical characteristics of PBC patients were summarized.The PBC patients were followed up through telephone follow-up and outpatient review results,and the risk factors for poor prognosis were summarized.The PBC-40 scale was used to understand the quality of life of the patients.Results:1.General information and imaging results: According to the data collected by the Affiliated Hospital of Yan ’an University,there were 20 male and 80 female patients with PBC,with a male-female ratio of 1:4.The average age was 60.8 years,10 patients were 50 years old or younger,and 90 patients were over 50 years old.The mean duration of PBC was 4.5 years.There were 15 PBC patients complicated with thyroid disease,followed by 11 Sjogren’s syndrome.Systemic lupus erythematosus(SLE),rheumatoid arthritis(RA)and spinal arthritis(SPA)were less common(2 cases,4 cases,2 cases,respectively).Results of PBC patients with different genders: There was a scientific and reasonable statistical difference between male and female combined with other autoimmune diseases and λ-Ig,P < 0.05.The female combined with autoimmune diseases was more than the male,while male λ-Ig was slightly lower than female patients.Results: There were significant differences in PLT,λ-Ig,CIV and CTP scores between the two groups with and without autoimmune diseases(P < 0.05).PLT of patients with simple PBC was lower than that of the combined group,and CIV and CTP were higher than that of the combined group,and λ-Ig was lower than that of the combined group.There was no statistically significant difference in the titer of AMA-M2 antibody between compensatory and decompensatory stages of liver function.2.Follow-up results of prognosis and quality of life in PBC patients:(1)Survival analysis: recurrent upper gastrointestinal bleeding and irregular use of UDCA were risk factors for poor prognosis in PBC patients,increasing the risk by4.49-fold and 3.52-fold respectively.(2)Quality of life: Referring to the PBC-40 scale,Among 78 PBC patients,symptom score distribution was 10.00(8.00,20.00),itching score distribution was 7.00(6.00,7.25),fatigue score distribution was 23.00(14.75,26.25),cognition score distribution was14.00(13.00,15.25),emotion score distribution was 5.00(4.00,6.00),social score distribution was 15.00(13.00,17.00).Correlation analysis was conducted between PBC scale score and hepatic function and other serologic indexes in 78 patients.The pruritus module score was positively correlated with ALP(R=0.65,P < 0.01),GGT(R=0.39,P <0.01)and TBA(R=0.29,P=0.009).The score of emotion module was significantly higher than that of ALT(R=0.22,P=0.04),AST(R=0.28,P=0.01),TBA(R=0.27,P=0.01),TBIL(R=0.64,P < 0.01),DBIL(R=0.65,P < 0.01)and IBIL(R=0.46,P < 0.01)were positively correlated.Conclusion:1.When the liver function damage in middle-aged and elderly women is mainly caused by the elevation of gallbladder stasis indicators such as ALP and GGT,they should be highly vigilant about the presence of PBC,and the diagnosis of this disease should also be checked for the presence of other extrahepatic autoimmune diseases.Other extrahepatic autoimmune diseases were mainly thyroid diseases and Sjogren’s syndrome.The onset of simple PBC was relatively hidden and the liver injury was more serious.AMA-M2 only exists as a diagnostic indicator,and the antibody titer has no significant correlation with the severity of disease.2.Repeated upper gastrointestinal bleeding and irregular use of UDCA are risk factors for poor prognosis in PBC patients.Gastroscopy and early intervention should be performed in all patients with middle-late decompensated PBC,and regular use of UDCA should be performed to reduce the risk of poor prognosis.3.The PBC-40 scale can well reflect the quality of life of PBC patients,whose symptoms,fatigue,itching,emotion,cognition and social interaction are all affected to varying degrees,with fatigue being the most prominent.PBC treatment should be a comprehensive process,not limited to delaying disease progression,but also to improving quality of life.