| 张玲玲,张会品,李桂英,孔燕,马兰.抗线粒体抗体、红细胞体积分布宽度与原发性胆汁性胆管炎熊去氧胆酸治疗应答效果的关系[J].中国医药导报,2024,21(4):100-103 |
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| 抗线粒体抗体、红细胞体积分布宽度与原发性胆汁性胆管炎熊去氧胆酸治疗应答效果的关系 |
| Relationship between anti-mitochondrial antibodies, erythrocyte volume distribution width, and response to Ursodeoxycholic Acid therapy in pri-mary biliary cholangitis |
| 收稿日期： 修订日期：2023-04-17 |
| DOI：10.20047/j.issn1673-7210.2024.04.23 |
| 关键词: 抗线粒体抗体 红细胞分布宽度 原发性胆汁性胆管炎 应答效果 |
| Key Words: |
| 基金项目:江苏省自然科学基金面上项目（BK20201131） |
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| 摘要:目的 探讨抗线粒体抗体（AMA）、红细胞分布宽度（RDW）与原发性胆汁性胆管炎熊去氧胆酸治疗应答效果的关系。 方法 采用回顾性研究方法，选取在南京市高淳人民医院2019年6月至2022年6月接受熊去氧胆酸治疗的126例原发性胆汁性胆管炎患者，根据患者治疗应答结局将其分为应答良好组60例和应答不良组66例，比较两组临床资料及治疗前的AMA、RDW水平，采用logistic回归模型分析AMA、RDW对原发性胆汁性胆管炎患者熊去氧胆酸应答效果的影响。 结果 应答不良组治疗前的谷丙转氨酶（GPT）、谷草转氨酶（GOT）、碱性磷酸酶、γ-谷氨酰转移酶（GGT）、总胆红素（TBil）、直接胆红素（DBil）、RDW水平均高于应答良好组，AMA阳性率低于应答良好组，差异有统计学意义（P＜0.05）。多因素分析结果显示，GPT（OR=1.941，95%CI：1.157～3.256）、GOT（OR=1.808，95%CI：1.073～3.045）、GGT（OR=1.504，95%CI：1.028～2.200）、TBil（OR=2.088，95%CI：1.279～3.408）、DBil （OR=1.735，95%CI：1.112～2.707）、RDW（OR=1.562，95%CI：1.091～2.236）、AMA阳性率（OR=0.584，95%CI：0.399～0.854）是原发性胆汁性胆管炎患者熊去氧胆酸治疗应答不良的独立影响因素（P＜0.05）。 结论 RDW增高、AMA阳性率降低是熊去氧胆酸治疗原发性胆汁性胆管炎患者应答不良的独立危险因素，临床中应予以重视。 |
| Abstract:Objective To investigate the relationship between anti-mitochondrial antibody (AMA), erythrocyte distribution width (RDW), and Ursodeoxycholic Acid therapy in patients with primary biliary cholangitis. Methods A retrospective study was conducted to select 126 patients with primary biliary cholangitis received Ursodeoxycholic Acid therapy in Nanjing Gaochun People’s Hospital from June 2019 to June 2022. According to the treatment response outcome, the patients were divided into good response group (60 cases) and poor response group (66 cases). Clinical data, and AMA, RDW levels before treatment were compared between the two groups. The effects of AMA and RDW on Ursodeoxycholic Acid response in patients with primary biliary cholangitis were analyzed by logistic regression model. Results The levels of glutamic-pyruvic transaminase (GPT), glutamic oxalic aminotransferase (GOT), alkaline phosphatase, γ-glutamyl transferase(GGT), total bilirubin (TBil), direct bilirubin (DBil), and RDW in poor response group were higher than those in good response group before treatment, and the positive rate of AMA was lower than that in good response group, the differences were statistically significant (P＜0.05). The results of multivariate analysis showed that GPT (OR=1.941, 95%CI: 1.157-3.256), GOT (OR=1.808, 95%CI: 1.073-3.045), GGT (OR=1.504, 95%CI: 1.028-2.200), TBil (OR=2.088, 95%CI: 1.279-3.408), DBil (OR=1.735, 95%CI: 1.112-2.707), RDW (OR=1.562, 95%CI: 1.091-2.236), and AMA positive rate (OR=0.584, 95%CI : 0.399-0.854) were independent factors of poor response to Ursodeoxycholic Acid therapy in patients with primary biliary cholangitis (P＜0.05). Conclusion Increased RDW and decreased AMA positive rate are independent risk factors for poor response to Ursodeoxycholic Acid therapy in patients with primary biliary cholangitis, which should be paid attention to in clinic. |
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