Yamazaki K, Nakadate I, Suzuki K, Sato S, Masuda T
First Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan.
Am J Gastroenterol. 1996 Mar;91(3):516-22.
Recent studies have shown the occurrence of eosinophilia in patients with primary biliary cirrhosis (PBC). To examine whether eosinophilia is indeed a distinctive feature of PBC, we performed extensive leukocyte differential analysis using a highly sophisticated hematology instrument. We also investigated the relationship between eosinophil dynamics and clinical features of PBC including the effects of ursodeoxycholic acid (UDCA) treatment.
A flow cytometry-based blood cell analyzer (Technicon H6000) was used to examine peripheral blood eosinophil counts in 38 patients with PBC and 131 patients with various liver deseases. We also performed eosinophil quantitation in 19 PBC patients before and after administration of UDCA for 4 wk.
Patients with PBC had significantly higher relative and absolute eosinophil counts when compared with other liver diseases (5.7 +/- 0.5% [p < 0.0001, mean +/- SEM] and 312 +/- 26 cells/microliter [p < 0.01], respectively). Twenty-one of 38 PBC patients (55%) exhibited relative eosinophilia. In patients with PBC, the eosinophil count was: 1) significantly higher in those with early histological stages (stage I-II, 6.5 +/- 0.5% vs stage III-IV, 4.4 +/- 0.7%,p < 0.05), 2) positively correlated with basophil count (p < 0.01), serum IgA levels (p < 0.05), and the degree of eosinophil infiltration in the portal tract (p < 0.01), and 3) markedly reduced by UDCA treatment (before: 5.9 +/- 0.7%, 307 +/- 37 cells/microliter; after: 2.8 +/- 0.03% [p < 0.001], 162 +/- 26 cells/microliter ¿p < 0.001]).
Eosinophilia is a common and distinctive feature of patients with PBC. UDCA ameliorates eosinophilia as well as liver function tests in PBC patients. Eosinophilia may be useful as one of the initial clues in the diagnosis of PBC, especially in its early stage.
近期研究显示原发性胆汁性肝硬化（PBC）患者中存在嗜酸性粒细胞增多现象。为了检验嗜酸性粒细胞增多是否确实是PBC的一个显著特征，我们使用了高度精密的血液学仪器进行了广泛的白细胞分类分析。我们还研究了嗜酸性粒细胞动态变化与PBC临床特征之间的关系，包括熊去氧胆酸（UDCA）治疗的效果。
使用基于流式细胞术的血细胞分析仪（Technicon H6000）检测38例PBC患者和131例各种肝病患者的外周血嗜酸性粒细胞计数。我们还对19例PBC患者在服用UDCA 4周前后进行了嗜酸性粒细胞定量分析。
与其他肝病患者相比，PBC患者的相对和绝对嗜酸性粒细胞计数显著更高（分别为5.7±0.5% [p<0.0001，平均值±标准误]和312±26个细胞/微升 [p<0.01]）。38例PBC患者中有21例（55%）表现出相对嗜酸性粒细胞增多。在PBC患者中，嗜酸性粒细胞计数：1）在组织学早期阶段（I-II期，6.5±0.5% vs III-IV期，4.4±0.7%，p<0.05）显著更高；2）与嗜碱性粒细胞计数（p<0.01）、血清IgA水平（p<0.05）以及门管区嗜酸性粒细胞浸润程度（p<0.01）呈正相关；3）经UDCA治疗后显著降低（治疗前：5.9±0.7%，307±37个细胞/微升；治疗后：2.8±0.03% [p<0.001]，162±26个细胞/微升 [p<0.001]）。
嗜酸性粒细胞增多是PBC患者的一个常见且显著的特征。UDCA可改善PBC患者的嗜酸性粒细胞增多以及肝功能检查结果。嗜酸性粒细胞增多可能作为PBC诊断的初始线索之一，尤其是在其早期阶段。
