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目的了解原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者血清中抗心磷脂抗体(anticardiolipin antibody,ACA)阳性率,探讨分析ACA对PBC病程影响及临床意义。方法 178例PBC患者按Child-Pugh标准分为A、B、C三级,并平行进行ACA(包括ACA-IgG、ACA-IgM和ACA-IgA)血清肝功能:血清总胆红素(serum total bilirubin,TBil)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和丙氨酸氨基转移酶(alanine aminotransferase,ALT),凝血功能:凝血酶原时间(prothrombin time,PT)、活化部分凝血酶时间(activated partial thromboplastin time,APTT)和血小板计数(platelet count,PLT),相关指标检测及统计分析各级间指标的差异。结果 PBC患者血清ACA阳性率(54.49%)明显高于正常对照组(2.00%),Child-Pugh三级内阳性率呈逐级升高,是随PBC病程加重而增加,AST和ALT含量明显升高,PT和APTT时间延长与ACA呈显著正相关(P<0.01),与PLT呈显著负相关(P<0.01),与TBil相关无显著性(P>0.05),ACA阳性、阴性两组比较差异均具有统计学意义(P<0.01)。结论 ACA与PBC病程发展有关,检测ACA对PBC病程的预测、疗效观察有一定的临床意义。
Objective To investigate the positive rate of anticardiolipin antibody (ACA) in the serum of patients with primary biliary cirrhosis (PBC) and to explore the influence of ACA on the course of PBC and its clinical significance. Methods One hundred and seventy-eight patients with PBC were divided into A, B and C according to the Child-Pugh criteria and the serum liver function of ACA (including ACA-IgG, ACA-IgM and ACA-IgA) bilirubin, TBil), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), coagulation function: prothrombin time (PT), activated partial thrombin (APTT) and platelet count (PLT) were detected and statistically analyzed. Results The positive rate of serum ACA in PBC patients (54.49%) was significantly higher than that in normal controls (2.00%). The positive rate of Child-Pugh increased gradually with the increase of PBC duration, and the levels of AST and ALT increased significantly There was a significant positive correlation between high, PT and APTT time and ACA (P <0.01), negative correlation with PLT (P <0.01), no correlation with TBil (P> 0.05), ACA positive and negative The differences were statistically significant (P <0.01). Conclusion ACA is related to the development of PBC course of disease. It is of clinical significance to detect the course of ACB on the course of PBC.