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[原发性胆汁性肝硬化患者的临床药房检查结果]

[Clinical-dispensary finding of patients with primary biliary cirrhosis].

作者信息

Chernev K, Bakalov V

出版信息

Vutr Boles. 1985;24(4):42-6.

PMID:2933878
Abstract

Ten patients with primary biliary cirrhosis (PBC) were clinically followed under the conditions of follow-up care. The diagnosis of the patients was made vie biochemical immunologic, histological and instrumental investigations. The average term for follow up was 4 years and 5 months. All patients were actively checked up by summoning every 6 months. The average incidence of hospitalization at the clinic was 1 year and 5 months. Pruritus preceded all other symptoms--1 year and 11 months on the average. Jaundice was established 1 year and 7 months after the manifestation of pruritus and the dirty greyish pigmentation of the skin--1 year and 11 months after pruritus. Hepatomegaly was established 1 year and 7 months after pruritus. Increased alkaline phosphatase, blood bilirubin and cholesterol were observed in all patients and increase of IgM in 80 per cent, and antimitochondrial antibodies--in 70 per cent. Xanthelasma and xanthoma were found only in patients with high levels of cholesterol and total fats. The treatment with dihydrocortison induced stomach complaints (erosive gastritis), intersifying bone chanes in 20 per cent of the patients. X-ray and instrumental methods have a relative value in making the diagnosis of PBC. It could be concluded from the complex treatment that corticosteroids give complications and the treatment with cholestiramine--to attenuation of pruritus. The average survival after making the diagnosis is 6 years.

摘要

10例原发性胆汁性肝硬化(PBC)患者在随访护理条件下进行临床跟踪。通过生化免疫、组织学和仪器检查对患者进行诊断。平均随访期为4年零5个月。所有患者每6个月被召集进行一次积极检查。在诊所的平均住院发生率为1年零5个月。瘙痒先于所有其他症状出现,平均为1年零11个月。瘙痒出现后1年零7个月出现黄疸,瘙痒出现后1年零11个月出现皮肤脏灰色色素沉着。瘙痒出现后1年零7个月出现肝肿大。所有患者均观察到碱性磷酸酶、血胆红素和胆固醇升高,80%的患者IgM升高,70%的患者抗线粒体抗体升高。睑黄瘤和黄瘤仅在胆固醇和总脂肪水平高的患者中发现。二氢可的松治疗引发胃部不适(糜烂性胃炎),20%的患者出现骨质变化加剧。X线和仪器检查方法在PBC诊断中具有相对价值。从综合治疗中可以得出结论,皮质类固醇会引发并发症,而消胆胺治疗可减轻瘙痒。确诊后的平均生存期为6年。

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