|本期目录/Table of Contents|

[1]李志艳,陈曦,张智超,等.原发性胆汁性胆管炎超声表现及与实验室指标的相关性研究[J].传染病信息,2018,02:135-139.
 LI Zhi-yan,Chen Xi,ZHANG Zhi-chao,et al.Correlation of ultrasonic manifestation and laboratory indexes in patients with primary biliary cholangitis[J].Infectious Disease Information,2018,02:135-139.
点击复制

原发性胆汁性胆管炎超声表现及与实验室指标的相关性研究(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2018年02期
页码:
135-139
栏目:
专题论著
出版日期:
2018-03-20

文章信息/Info

Title:
Correlation of ultrasonic manifestation and laboratory indexes in patients with primary biliary cholangitis
作者:
李志艳陈曦张智超张岩峰冯松应明华杨秀梅
100039 北京,解放军第三〇二医院超声科(李志艳、 陈曦、张智超、张岩峰、冯松、应明华);830013 乌鲁木齐,新 疆第六人民医院功能科(杨秀梅)
Author(s):
LI Zhi-yan Chen Xi ZHANG Zhi-chao ZHANG Yan-feng FENG Song YING Ming-hua YANG Xiu-mei*
Department of Ultrasound, 302 Military Hospital of China, Beijing 100039, China
关键词:
原发性胆汁性胆管炎超声病理实验室检查
Keywords:
primary biliary cholangitis ultrasound pathology laboratory examination
分类号:
R445.1;R575.7
DOI:
10.3969/j.issn.1007-8134.2018.02.010
文献标识码:
A
摘要:
目的 探讨原发性胆汁性胆管炎(primary biliary cholangitis, PBC)的超声表现,分析不同病理分期的生化、 免疫指标的差异。方法 回顾性分析病理确诊的75 例PBC 患者的超声表现、病理资料及临床实验室检查结果,总结不 同病理分期超声表现,分析PBC 患者的病理分期与肝功能、免疫学指标的相关性。结果 不同病理分期的PBC 患者超声 表现不同:Ⅰ期患者超声表现正常或回声稍增粗,Ⅱ期患者超声表现为回声增粗及呈条索样改变,Ⅲ、Ⅳ期患者超声表现 多呈条索及结节样改变,且部分患者可出现门静脉周围的低回声区。对实验室检查与纤维化病理分期的分析显示,ALT、 ALP 水平在4 期之间差异有统计学意义(P 均< 0.05), 两两比较发现Ⅲ期ALT、ALP 水平大于Ⅰ、Ⅱ期,其余各期之 间差异无统计学意义(P 均> 0.05);IgG 水平在4 期患者之间差异有统计学意义(P < 0.05),两两比较发现Ⅳ期水平 大于Ⅰ期,其余各期之间差异无统计学意义(P 均> 0.05)。结论 超声在PBC 各病理分期的特征性影像学改变结合生化 免疫指标,可对PBC 提供客观的无创诊断依据,并与PBC 的病理纤维化程度具有相关性。
Abstract:
Objective To observe ultrasonic manifestation in patients with primary biliary cholangitis (PBC) and analyze the differences of biochemical and immune indexes at different pathological stages. Methods Ultrasonic manifestation, pathological data and clinical laboratory findings of 75 patients with pathologically diagnosed PBC were retrospectively analyzed to summarize ultrasonic manifestation at different pathological stages, and to analyze the correlation of pathological staging with liver function and immunological indexes in PBC patients. Results PBC patients exhibited different ultrasonic manifestations at different pathological stages. Normal ultrasound and slightly thickening echoes were shown at stage I. Echo thickening and stripe-like changes were found at stage II. Stripe and nodular changes were dominant at stage III and Ⅳ . Hypoechoic regions around the portal vein appeared in some patients. Statistical analysis of laboratory examination and pathological staging of fibrosis showed that ALT and ALP levels showed statistically significant difference among 4 stages (P < 0.05), levels of ALT, ALP at stage III were higher than those at stages I and II, while the differences among other stages were not statistically significant (P > 0.05); the differences of lgG level among 4 stages were statistically significant (P < 0.05), lgG level at stage Ⅳ was higher than that at stage I, while the differences among other stages were not statistically significant (P > 0.05). Conclusions The characteristic ultrasonic imaging changes at each pathological stage of PBC, in combination with biochemical immunity indexes, will provide objective basis for noninvasive diagnosis of PBS, which are correlated with the severity of pathological fibrosis of PBC.     

参考文献/References

[1] Carey EJ, Ali AH, Lindor KD. Primary biliary cirrhosis[J]. Lancet, 2015, 386(10003):1565-1575.
[2] 邱春婷. 原发性胆汁性肝硬化56例临床分析[J].传染病信息, 2013,26(3):184-185.
[3] Ahren EH Jr, Payne MA, Kunkel HG, et al. Primary biliary cirrhosis[J]. Medicine(Baltimore), 1950, 29(4):299-364.
[4] Beuers U, Gershwin ME, Gish RG, et al. Changing nomenclature for PBC: from cirrhosis to cholangitis[J]. Clin Res Hepatol Gastroenterol, 2015, 39:57-59.
[5] Heathcote EJ. Management of primary biliary cirrhosis. The Amefican association for the study of liver diseases practice guidelines[J]. Hepatology, 2000, 31(4):1005-1013.
[6] 孟繁坤. 肝纤维化的超声诊断[J]. 中华肝脏病杂志,2008, 16(3):175-176.
[7] Neuberger J. Primary biliary cirrhosis[J]. Lancet, 1997, 350:875-879.
[8] Boonstra K, Beuers U, Ponsioen CY. Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis: a systematic review[J]. J Hepatol, 2012, 56(5):1181-1188.
[9] Taakeyama Y, tsuchiya N, Kunimoto H, et al. Gadolinium ethoybenzyl-diethy lenetriamine pentaacetic acid-enhanced agnetic resonance imaging as a useful detection method for dvanced primary biliary cirrhosis[J]. Hepatol Res, 2015, 45(10):108- 114.
[10] 徐芸,李建生,汪群炭. 原发性胆汁性肝硬化临床分期的意 义[J]. 中华消化杂志,2008,28(1):7-10.
[11] Dhirapong A, Yang GX, Nadler S, et al. Therapeutic effect of cytotoxic tlymphocyte antigen 4/immunoglobulin on a murine model of primary biliary cirrhosis[J]. Hepatology, 2013, 57(2):708- 715.
[12] Muratori P, Muratori L, Ferrari R, et al. Characterization and clinical impact of antinuclear antibodies in primary biliary cirrhosis [J]. Am J Gastroenterol, 2003, 98(2):431-437.
[13] Baldursdottir TR, Bergmann OM, Jonasson JG, et al. The epidemiology and natural history of primary biliary cirrhosis: a nationwide population-based study[J]. Eur J Gastroenterol Hepatol, 2012, 24(7):824-830.
[14] Chan CW, Carpenter JR, Rigamonti C, et al. Survival following the development of ascites and/ or peripheral oedema in primary biliary cirrhosis: a staged prognostic model[J]. Scand J Gastroenterol, 2005, 40(9):1081-1089.
[15] Tomiyama Y, Takenaka K, Kodama T, et al. Risk factors for survival and the development of hepatocellular carcinoma in patients with primary biliary cirrhosis[J]. Intern Med, 2013, 52(14):1553-1559.
[16] Cavazza A, Caballerfa L, Floreani A, et al. Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: comparative analysis from two centers[J]. Hepatology, 2009, 50(4):1162-1168.

备注/Memo

备注/Memo:
[基金项目] 国家自然科学基金(81471680)
[通信作者] 杨秀梅,E-mail: lzyyuer@sina.com
更新日期/Last Update: 2018-03-20