Zhu Jiang-yi, Li Zeng-shan, Yan Wei, Wang Jan-hong, Zhou Xin-min, Wang Rui-an, Huang Xiao-feng, Shi Yong-quan, Dong Xu-yang, Han Zhe-yi, Han Ying
Xijing Digestive Disease Hospital of the Forth Military Medical University, Xi'an 710032, China.
Zhonghua Gan Zang Bing Za Zhi. 2010 Oct;18(10):735-9. doi: 10.3760/cma.j.issn.1007-3418.2010.10.004.
To assess the therapeutic effect of primary biliary cirrhosis(PBC) in different stages with ursodeoxycholic acid (UDCA).
91 patients with PBC were divided into 4 periods based on levels of liver test and symptoms. Clinical manifestations, biochemical changes and pathological changes were observed for 2 years on UDCA therapy.
The levels of alkaline phosphatase (ALP) and glutamyltranspetidase (GGT) at the second PBC period were declined by 51.9% and 67.3% respectively after a 6-month UDCA therapy. The biochemical responses were 81.25% (Paris criteria) and 93.75% (Barcelona criteria). The levels of ALP and GGT at the third PBC period were declined by 48.8% and 46.6% after 6 months of UDCA therapy, and the biochemical responses were 36.84% (Paris criteria) and 57.89% (Barcelona criteria). Symptoms like fatigue, pruritus and jaundice after UDCA therapy were better than before. Same results also appeared at the fourth period. 11 patients in different periods underwent pathological examinations before and after UDCA therapy and no progression found in the first and the second periods, however difference found in the third and the fourth periods with the lymphocyte infiltration was less than before UDCA treatment.
Good biochemical responds appear in patients at the second, third and forth periods after UDCA therapy, in which the second period is best. Symptoms could be improved after UDCA treatment. Early UDCA therapy is benefit for slowing down the progression of liver pathology.
评估熊去氧胆酸(UDCA)对不同阶段原发性胆汁性肝硬化(PBC)的治疗效果。
根据肝功能检查结果和症状将91例PBC患者分为4期。对接受UDCA治疗的患者进行2年的临床表现、生化变化及病理变化观察。
在PBC第二期,经过6个月的UDCA治疗后,碱性磷酸酶(ALP)和谷氨酰转肽酶(GGT)水平分别下降了51.9%和67.3%。生化应答率根据巴黎标准为81.25%,根据巴塞罗那标准为93.75%。在PBC第三期,经过6个月的UDCA治疗后,ALP和GGT水平分别下降了48.8%和46.6%,生化应答率根据巴黎标准为36.84%,根据巴塞罗那标准为57.89%。UDCA治疗后的疲劳、瘙痒和黄疸等症状较治疗前有所改善。第四期也出现了同样的结果。11例处于不同阶段的患者在UDCA治疗前后接受了病理检查,第一期和第二期未发现病情进展,然而在第三期和第四期发现淋巴细胞浸润较UDCA治疗前有所减少。
UDCA治疗后,第二、三、四期患者出现良好的生化应答,其中第二期最佳。UDCA治疗后症状可得到改善。早期UDCA治疗有利于减缓肝脏病理进展。