我国一般人群原发性胆汁性胆管炎患病率及其影响因素的系统综述

刘智成; 王资隆; 郑佳睿; 谢艳迪; 宋广军; 封波

doi:10.3969/j.issn.1001-5256.2023.02.011

我国一般人群原发性胆汁性胆管炎患病率及其影响因素的系统综述

DOI: 10.3969/j.issn.1001-5256.2023.02.011

北京大学人民医院肝病科，北京 100044

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：刘智成负责文献检索，撰写论文；王资隆、郑佳睿负责文献筛选和整理数据；谢艳迪、宋广军负责修改论文；封波负责拟定写作思路，指导撰写论文。

详细信息

通信作者:
封波，fengbo@pkuph.edu.cn(ORCID: 0000-0001-5084-6715)

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出版历程
- 收稿日期: 2022-06-19
- 录用日期: 2022-09-13
- 出版日期: 2023-02-20

Prevalence of primary biliary cholangitis in the Chinese general population and its influencing factors: A systematic review

Department of Hepatology, Peking University People's Hospital, Beijing 100044, China

More Information

Corresponding author: FENG Bo, fengbo@pkuph.edu.cn (0000-0001-5084-6715)

摘要

摘要: 目的系统回顾原发性胆汁性胆管炎(PBC)流行病学研究，了解中国一般人群PBC的患病率及其影响因素。方法检索PubMed、Embase、The Cochrane Library、CNKI和万方自建库至2022年3月31日发表的有关我国PBC流行病学研究文献。2位研究者独立筛选文献、提取资料，然后进行分析。结果共纳入9篇研究文献。AMA阳性率及PBC患病率分别为1 049.05/10万(范围159.65/10万~2 287.40/10万)和123.68/10万(范围42.70/10万~276.59/10万)。AMA阳性率在男女中分别为636.51/10万(范围52.55/10万~1 164.33/10万)和1 265.47/10万(范围225.23/10万~1 704.93/10万)，AMA患病率男女比为1∶1.99。PBC患病率在男女中分别为40.81/10万(范围23.54/10万~75.10/10万)和148.71/10万(范围77.36/10万~214.91/10万)，PBC患病率男女比为1∶3.64。结论不同研究我国一般人群AMA阳性率及PBC患病率差别较大，其主要受年龄、性别及地区影响。从整体看，AMA阳性率及PBC患病率随年龄增大而增大，年龄≥50岁AMA阳性率明显高于年龄＜50岁。AMA阳性率远高于PBC患病率。AMA阳性人群和PBC患者女性明显多于男性，性别对AMA的影响小于其对PBC的影响。
- 原发性胆汁性胆管炎 /
- 流行病学 /
- 患病率
Abstract: Objective To systematically review the epidemiological studies on primary biliary cholangitis (PBC), and to investigate the prevalence rate of PBC in the Chinese general population and its influencing factors. Methods PubMed, Embase, The Cochrane Library, CNKI, and Wanfang Data were searched for articles on the epidemiology of PBC in China published up to 31th March 2022. Two researchers independently performed screening and data extraction, and then related analyses were performed. Results A total of 9 articles were included. The positive rate of AMA was 1 049.05/100 000 (ranging fr om 159.65/100 000 to 2287.40/100 000), and the prevalence rate of PBC was 123.68/100 000 (ranging from 42.70/100 000 to 276.59/100 000). The positive rate of AMA was 636.51/100 000 (ranging from 52.55/100 000 to 1 164.33/100 000) in men and 1 265.47/100 000 (ranging from 225.23/100 000 to 1 704.93/100 000) in women, with a male/female ratio of 1∶1.99 for the prevalence rate of AMA. The prevalence rate of PBC was 40.81/100 000 (ranging from 23.54/100 000 to 75.10/100 000) in men and 148.71/100 000 (ranging from 77.36/100 000 to 214.91/100 000) in women, with a male/female ratio of 1∶3.64 for the prevalence rate of PBC. Conclusion Different studies show great differences in the positive rate of AMA and the prevalence rate of PBC in the Chinese general population, which is mainly affected by sex, age, and region. The positive rate of AMA and the prevalence rate of PBC increase with age, and the patients aged ≥50 years have a significantly higher positive rate of AMA than those aged < 50 years. The positive rate of AMA is significantly higher than the prevalence rate of PBC. There are significantly more women than men in the AMA-positive population and the PBC patients, and the influence of sex on AMA is lower than that on PBC.
- Primary Biliary Cholangitis /
- Epidemiology /
- Prevalence

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图 1 文献筛选流程

Figure 1. Flowchart of study selection

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图 2 AMA-M2阳性率随时间变化趋势

注：a, 所有患者; b, 男性患者；c, 女性患者。

Figure 2. Temporal trend of AMA-M2 prevalence

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图 3 PBC患病率随时间变化趋势

注：a, 所有患者; b, 男性患者；c, 女性患者。

Figure 3. Temporal trend of PBC prevalence

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图 4 不同地区AMA-M2阳性率及PBC患病率分布情况

注：a, AMA-M2;b, PBC。

Figure 4. Prevalence of AMA-M2 and PBC by geographical area

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表 1 纳入文献的基本特征

Table 1. Characteristics of included studies

第一作者	发表年份	收集病例年份	地区	AMA-M2阳性例数(男/女)	AMA-M2阳性率(男/女，10万)	不同年龄段AMA-M2阳性率
Jiang等^[12]	2003	2000	上海	8(1/7)	159.65(52.55/225.23)	-
Liu等^[13]	2010	2006	广州	35(15/20)	430.72(353.11/515.73)	-
郭亚平等^[15]	2014	2011	河北	156(32/124)	743.92(303.32/1 190.02)	-
Chen等^[11]	2016	2013	上海	133(33/100)	699.56(397.11/934.40)	18~49岁: 16.9 (0/41.5); 50~59岁: 1 740.5 (714.3/2 251.2); 60~69岁: 578.9 (161.2/856.2); 70~79岁: 1 147.4 (942.8/1 219.5); 80~89岁: 1 187.9 (1 077.6/1 243.2); ≥90岁: 1574.8 (3 225.8/621.1)
叶震璇等^[18]	2018	2015	贵州	438(135/303)	1 201.35(722.43/1 704.93)	≤ 40岁: 739.3; 41~60岁: 1 363.5； ≥ 61岁: 2 601.0；
刘晓萍等^[16]	2018	2015	山西	209(-)	2 287.40	-
瞿国英等^[17]	2018	2017	上海	175(69/106)	1 075.93(843.73/1 310.75)	≤ 30岁: 18.45(0/36.97); 31~45岁: 1 083.27(901.19/1 267.06); 46~60岁: 1 831.79(1 567.23/2 107.48); ≥ 61岁: 4 597.70(2 652.52/6 403.94)
郑佳等^[19]	2019	2013和2017	青海	26(10/16)	1 110.16(725.16/1 661.47))	＜30岁: 760.46 ＜50岁: 781.76 ≥50岁: 2 205.88
曲颖等^[14]	2022	2012—2014	上海	245(97/148)	1 323.25(1 164.33/1 453.26)	-
总计				1425(392/824)	1 049.05(636.51/1 265.47)	-

第一作者	PBC患者例数(男/女)			PBC患病率(男/女，10万)		不同年龄段PBC患病率
Jiang等^[12]	3(0/3)			59.87(0/96.53)		-
Liu等^[13]	4(1/3)			49.22(23.54/77.36)		＞40岁: 女性155.8
郭亚平等^[15]	58(-)			276.59(-)		-
Chen等^[11]	25(2/23)			131.50(24.07/214.91)		50~59岁: 316.5 (0/473.9) 60~69岁: 85.8 (0/142.7) 70~79岁: 174.6 (67.3/228.7) 80~89岁: 360.0 (107.8/486.5)
叶震璇等^[18]	39(10/29)			106.97(53.51/163.18)		≤ 40岁: 24.04 41~60岁: 123.40 ≥ 61岁: 415.05
刘晓萍等^[16]	10(4/6)			109.45(75.10/157.44)		-
瞿国英等^[17]	16(4/12)			98.37(48.91/148.39)		31~45岁: 48.50(32.19/64.98) 46~60岁: 154.80(50.56/263.43) ≥61岁: 894.00(530.50/1231.53)
郑佳等^[19]	1(0/1)			42.70(0/103.84)		-
曲颖等^[14]	12(2/10)			64.81(24.01/98.19)		-
总计	168(23/87)			123.68(40.81/148.71)		-

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