Clinic Characteristics Of 141 Cases With Primary Biliary Cholangitis

Objective : To observe the information and characteristics(General information,clinical manifestations,blood biochemistry tests,autoimmune,imaging,etc.)and it's characteristics,to explore the link between anti-Ro-52 antibody and PBC,PBC patients with esophageal / gastric varices to do a simple prediction)of 141 patients diagnosed with primary biliary cholangitis(PBC),to do a simple prediction of esophageal / gastric varices,to explore the link between anti-Ro-52 antibody and PBC and then further improve the understanding of the disease.Method:The general information,clinical symptoms and signs,clinical complications and complications,serum biochemical markers,autoantibodies,endoscopy,imaging and Fibro Scan examination date of 141 patients with primary biliary cholangitis who were treated with complete case data from June 2011 to December 2016 in our hospital were retrospectively analyzed.The same patient was hospitalized only for the first time.Result:1.In this study,26 cases(18.4%)were male and 115(81.6%)were male.The ratio of male to female was 1: 4.42,and the average age of all cases was 57.8 ± 10.8 years.Natural progress240(60-700)days and average hospitalization 11(8-15)days.2.Common clinical manifestations of PBC is jaundice,hepatosplenomegaly,fatigue,loss of appetite,upper abdominal discomfort,ascites,pruritus,dry eye syndrome and xerostomia,edema of the legs,palmar erythema,spider nevus and so on.3.The main complications were: electrolyte imbalance(37 cases),gastrointestinal bleeding(20 cases),infection(14 cases),hepatic encephalopathy(2 cases);the main complications were: Sjogren's syndrome(11 cases),diabetes(6 cases),Hashimoto's thyroiditis(5 cases),rheumatoid arthritis(1 case),systemic lupus erythematosus(1 case),adult STILL disease(1 case),systemic sclerosis(1 case).4.Serum biochemical tests to ALP and GGT increased mainly [261.6(155.5-489.1)U/L,179.1(81.0-430.5)U/L respectively],AST,ALT moderately elevated [69.0(43.0-114.0)U/L,54.0(32.0-93.5)U/L U / L respectively],these two indicators in the early stage of disease increased significantly,to the late disease is not obvious.Total bilirubin was the upper limit.Total bile acid was higher than the normal upper limit of 2 times and immunoglobulin increased(3.90 ± 3.18)G / L.5.There were 91 patients(64.5%)with AMA-positive antibody,120 patients(85.1%)with AMA-M2 positive,ANA positive in 125 patients(88.7%),31 patients(22.0%)with anti-(46.8%)were positive for Ro-52 antibody,22(15.6%)were positive for SSA and 15(10.7%)were positive for SSB.6.There were 35 cases(53.9%)of endoscopic esophageal varices,9 cases(13.9%)had gastric varices,8 cases(12.3%)showed ulcers and / or erosion,8 cases(12.3%)had Portal hypertension gastropathy,29 cases(44.6%)suggest chronic gastritis.8 cases(12.3%)had esophageal varices and gastric varices.7.A total of 118 patients underwent abdominal ultrasound,ultrasound showed 98 cases(83.1%)liver diffuse lesions,38 cases(32.2%)ascites,81 cases(68.6%)there hepatosplenomegaly,35 cases(29.7%)prompted the door Veins / splenic veins widened or portal flow decreased,5 cases suggested(4.2%)cholestasis,4 cases(3.4%)suggested portal vein thrombosis.6 cases(5.1%)were normal ultrasound;41 patients underwent upper abdominal CT scan or plain scan,the results showed that 25 cases(61.0%)cirrhosis,14 cases(34.2%)showed ascites,29 cases(70.7%)with splenomegaly,7 cases(17.1%)showed portal hypertension,19 cases(46.3%)showed esophageal varices,16 cases(39.0%)showed gastric varices.There were 8 cases(19.5%)with esophageal endoscopic varicose veins and varicose veins.8.26 patients underwent Fibro Scan and 9(34.6%)were in the cirrhosis stage.141 patients underwent Mayo scores at a score of 5.7 ± 1.5.There was a significant positive correlation between Mayo risk score and Fibro Scan staging(correlation coefficient 0.948,P = 0.000).9.Male group was statistically different from the course of female group(P=0.023),AMA was statistically different(P = 0.030).There were no significant differences between the two groups in clinical manifestation,biochemical examination and imaging examination.10.Ro-52 positive group was more likely to appear dryness syndrome and ascites than in the negative group.There were statistically significant differences(P = 0.014 and 0.012,respectively).Sjogren's syndrome appears positive group than negative group(P = 0.002).Ig G were higher than those in the negative group(P = 0.023),but CHE was lower in the negative group(P = 0.008).11.In the diagnostic value of esophageal varicose veins,when the Mayo score was equal to 4.8,the platelet count was 130 × 109 / L,the serum albumin was 38.6 g / L,the Youden index was the highest,these indicators of esophageal varices have a certain diagnostic value.Total bilirubin and prothrombin time in the diagnosis of varicose veins are limited.Conclusion:Primary biliary cholangitis mainly involving middle-aged women,female patients have longer disease course.The main clinical manifestations is jaundice,hepatosplenomegaly,fatigue,loss of appetite,epigastric discomfort,ascites,pruritus,dry eye syndrome and xerostomia.Symptoms are lacking in specificity.Early patients with no obvious symptoms.In the late stages of disease with cirrhosis complications,but also with autoimmune diseases,such as Sjogren's syndrome.The most valuable noninvasive method is serum AMA / AMA-M2 antibody.The presence of Ro-52 antibody may be predictive of ascites in patients.Ro-52-negative patients may have lower liver synthesis function.Patients with Mayo> 4.8,platelets <130 × 109 / L,serum albumin <38.6g / L should regularly check endoscopy.Currently the most effective drug for treatment is UCDA.We need to find a more effective and safe way to diagnose early treatment early.