Tobias R, Wright J P, Kottler R E, Bornman P C, Price S K, Hatfield A, Marks I N
S Afr Med J. 1983 Feb 12;63(7):229-35.
Patients with inflammatory bowel disease and serum alkaline phosphatase persistently raised to more than twice the normal level were investigated to assess the frequency of primary sclerosing cholangitis (PSC) in the Gastro-intestinal Clinic from 1975 to 1981. Twelve patients had a persistently raised alkaline phosphatase level of hepatic origin, 9 out of 250 with ulcerative colitis and 3 out of 164 with Crohn's disease. PSC was demonstrated in 8(3%) of the patients with ulcerative colitis, and carcinoma of the pancreas in the remaining 1. Three of the patients with PSC also had gallstones. The colitis antedated the biliary symptoms and signs in all but 1 patient. There was no correlation between the duration, extent and activity of the colitis and the development and outcome of the liver involvement. Investigations in the 3 patients with Crohn's disease revealed the presence of PSC in 2 (1,2%) and chronic active hepatitis in the 3rd. Of the 2 with PSC, one had cholelithiasis and has had recurrent episodes of cholangitis. The other has had only mild symptoms.
对炎症性肠病患者以及血清碱性磷酸酶持续升高至正常水平两倍以上的患者进行了调查，以评估1975年至1981年期间胃肠病诊所原发性硬化性胆管炎（PSC）的发生频率。12例患者的碱性磷酸酶水平持续升高且源于肝脏，其中溃疡性结肠炎患者250例中有9例，克罗恩病患者164例中有3例。溃疡性结肠炎患者中有8例（3%）被证实患有PSC，其余1例患有胰腺癌。3例PSC患者还患有胆结石。除1例患者外，所有患者的结肠炎均早于胆道症状和体征出现。结肠炎的病程、范围和活动度与肝脏受累的发生及转归之间无相关性。对3例克罗恩病患者的检查发现，其中2例（1.2%）患有PSC，第3例患有慢性活动性肝炎。在这2例PSC患者中，1例患有胆石症且反复发生胆管炎。另1例仅有轻微症状。
