Tsukada Y, Akiyama N, Suda Y, Saitou T, Uchikoshi Y, Ishihara K, Shimizu T, Asakura H
Third Department of Internal Medicine, Niigata University School of Medicine, Japan.
J Gastroenterol Hepatol. 1989;4 Suppl 1:60-2.
A retrospective study was made of the clinical features, especially oesophageal varices, of 93 patients with PBC. The 5 year survival rate of asymptomatic PBC patients was 88.7% and that of symptomatic PBC was 43.7%. The 5 year survival rate of the group with oesophageal varices was 44.0% and that of the group without varices was 68.8%. The 5 year survival rate of the patients with high-risk varices was 39.1% and of those without high-risk varices was 67.9%. Management of variceal bleeding in PBC patients was considered very difficult. In prognostic study, the patients with the prophylactic therapy were better than the patients with emergency or elective therapy. The antiM8 (a subtype of antimitochondrial antibody) positive patients had poor prognosis compared with antiM8 negative patients. Therefore, it was concluded from these data that some kind of treatment was necessary for patients with high-risk varices. In particular, it was considered necessary to monitor closely the patients whose serum alkaline phosphatase levels had remained high.
对93例原发性胆汁性肝硬化（PBC）患者的临床特征，尤其是食管静脉曲张进行了回顾性研究。无症状PBC患者的5年生存率为88.7%，有症状PBC患者的5年生存率为43.7%。有食管静脉曲张组的5年生存率为44.0%，无静脉曲张组为68.8%。高危静脉曲张患者的5年生存率为39.1%，无高危静脉曲张患者为67.9%。PBC患者的静脉曲张出血处理被认为非常困难。在预后研究中，接受预防性治疗的患者比接受急诊或择期治疗的患者预后更好。抗M8（抗线粒体抗体的一个亚型）阳性患者与抗M8阴性患者相比预后较差。因此，从这些数据得出结论，高危静脉曲张患者需要某种治疗。特别是，认为有必要密切监测血清碱性磷酸酶水平持续升高的患者。
