Retrospective Study On Clinical Data Of Primary Biliary Cirrhosis Has Identification And Judgment Value

Objective: The purpose of this study is to compare the clinical data of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and healthy people,and to study laboratory indicators that have differential value for PBC;compare the relevant laboratories of PBC patients with different courses Indicators,to explore indicators that have judgment value for judging the condition of PBC patients,so as to improve the understanding and diagnosis and treatment of the disease,and reduce the misdiagnosis rate.Methods: Collect and sort out 63 PBC cases and 30 AIH cases who were hospitalized in the Liver Disease Department of Tai zhou People’s Hospital from January 2015 to June 2020.At the same time,35 healthy people who matched the age and gender of the medical examination center of our hospital with the case group were collected as the healthy control group.2.Use single factor analysis,multivariate Logistic multivariate analysis,etc.to screen out clinical indicators that are meaningful for the identification of PBC,and analyze the diagnostic efficacy of related indicators by drawing ROC curves.3.Compare the clinical data of PBC patients without cirrhosis group and cirrhosis group,screen out valuable indicators for judging the condition of PBC patients,and calculate the effectiveness of related indicators for judging the condition of PBC patients.Results:1.Both the PBC and AIH groups are more common in middle-aged and elderly women.The proportions of women in the two groups are 90.47% and 86.67%,respectively.The average age is 56.89±10.40 and 53.27±10.17 years old.There was no significant difference between the two groups in age and gender(P>0.05).2.The positive rates of antinuclear antibodies and anti-AMA-M2 antibodies in the PBC group were 87.30% and 77.78%,respectively.The above antibody indicators are significantly different among the three groups(P<0.05);HGB,TP,ALB,AST,ALP,GGT,TBA,CHE,UA,CHOL,HDL-C,LDL-C,Ig G,Ig A,Ig M were statistically different between the three groups(P<0.05).The indicators with significant differences between the three groups were compared between the two groups and found found that CHOL had significant differences between the PBC and AIH groups(P <0.05),there are differences in LDL-C between the PBC and AIH groups(P<0.1),the PBC group has significant differences from the other two groups at the same time: ALP,GGT,Ig M,anti-AMA-M2 antibody(P<0.05),these meaningful indicators between the two groups were compared by multiple logistic regression analysis Later,it was found that ALP and Ig M are meaningful for the identification of PBC,and their relative risk(OR value)is greater than 1(P<0.05).Draw receiver operating characteristic curve(ROC)for single index and combined index,the area under the curve(AUC)for the diagnosis of PBC by ALP=0.951(95 % CI : 0.897-1.000),and the AUC for the diagnosis of PBC by Ig M=0.845(95% CI: 0.756-0.934),the sensitivity of ALP and Ig M to distinguish PBC were 96.1% and 62.7%,and the specificity was 86.4% and 99.5%,respectively.The ALP combined with Ig M in the diagnosis of PBC has AUC=0.953(95%CI:0.905-1.000),sensitivity is 95.5%,specificity is 90.2%;the equation is established:Logistic(ALP+Ig M)=6.230-0.038×ALP-0.884×Ig M.3.HGB,WBC,PLT,TBIL,ALB,ALT,CHE,CHOL,TG,LDL-C,Ig G,C3,C4,PIIINP,IV-C and LN indexes were significantly different between the non-cirrhosis group and the cirrhosis group(P<0.05).After a binary logistic multivariate analysis,it was found that PLT,ALB,and CHE are valuable for disease judgment.The OR values of the three indicators are all less than 1,indicating that the lower the value of PLT,ALB and CHE,the more prone the disease is to cirrhosis(P< 0.05).Draw the ROC curve of PLT,ALB,CHE combined index to judge the condition of PBC,its AUC=0.890(95% CI: 0.799-0.981),the sensitivity is 90.9%,and the specificity is 90%.Conclusions:1.PBC is more common in women aged 40-60.The positive rates of PBC antinuclear antibody and anti-AMA-M2 are very high,87.30% and 77.78% respectively.The above antibody indicators are significantly different among the three groups(P<0.05).2.ALP and Ig M have a certain clinical value in the identification of PBC.The sensitivity of the identification of PBC is 96.1%,62.7%,86.4%,and 99.5%,respectively;the sensitivity of combining ALP and Ig M in the diagnosis of PBC is95.5%,90.2%,The detection performance index is sensitive and sufficiently good,and has certain clinical value for the diagnosis of PBC,which can be used as a reference for the clinical diagnosis of the disease(P <0.05);the equation can be established through the binary Logistic: Logistic(ALP + Ig M)= 6.230-0.038×ALP-0.884×Ig M.3.PLT,ALB,and CHE have the value of judging the progression of PBC disease.The OR of the three indicators is less than 1,indicating that the lower the value of PLT,ALB,and CHE,the more prone the disease is to liver cirrhosis(P<0.05);The sensitivity of combined PLT,ALB,CHE to judge the condition of PBC is 90.9%,and the specificity is 90%.In summary,ALP and Ig M can be used to diagnose PBC with high diagnostic accuracy.The combination of these two indicators has better diagnostic accuracy for PBC than a single indicator;PLT,ALB,CHE can be used to assess the condition of patients with PBC.In clinical practice,it can be combined with three indicators to assess the condition of patients.