中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 9
Sep.  2024
Turn off MathJax
Article Contents

Clinical features of primary biliary cholangitis patients with negative or positive anti-mitochondrial antibody: A comparative study

DOI: 10.12449/JCH240910
Research funding:

National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine (zyyzdxk-2023005)

More Information
  • Corresponding author: ZHOU Guiqin, zhouguiqin@ccmu.edu.cn (ORCID: 0000-0002-1035-0181)
  • Received Date: 2023-12-10
  • Accepted Date: 2024-01-29
  • Published Date: 2024-09-25
  •   Objective  To investigate the differences in clinical features between the primary biliary cholangitis (PBC) patients with negative or positive anti-mitochondrial antibody (AMA) by analyzing related immune and biochemical parameters.  Methods  This study was conducted among the patients who attended Beijing Ditan Hospital, Capital Medical University, from January 2013 to December 2022 and were diagnosed with PBC, and they were divided into AMA negative group with 139 patients (24.5%) and AMA positive group with 428 patients (75.5%). Propensity score matching at a ratio of 1∶1 was performed with age and sex as matching factors and a matching tolerance of 0.06. Liver function, coagulation, and immune parameters on admission were analyzed, as well as the changes in liver function and other indicators after 6 months of treatment and the response to ursodeoxycholic acid (UDCA) at 6 and 12 months of treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups.  Results  There were 139 AMA-negative PBC patients and 139 AMA-positive PBC patients after propensity score matching. Compared with the AMA positive group on admission, the AMA negative group had significantly lower levels of direct bilirubin and globulin (Glo) and significantly higher levels of albumin, albumin/globulin ratio, prealbumin, and fibrinogen (all P<0.05). After 6 months of UDCA treatment, there were significant differences in Glo and prealbumin between the AMA negative group and the AMA positive group (P<0.05). Both the AMA negative group and the AMA positive group had an increase in prealbumin after 6 months of treatment, and the AMA negative group had a significantly greater increase than the AMA positive group (U=41.00, P=0.015). After UDCA treatment for 6 and 12 months, there was no significant difference in treatment response to UDCA between the AMA negative group and the AMA positive group (all P>0.05).  Conclusion  After matching for age and sex, compared with the AMA-positive PBC patients, the AMA-negative PBC patients tend to have a milder degree of liver inflammation and damage, significantly greater improvements in inflammation and liver synthesis ability after UDCA treatment, and better response to UDCA.

     

  • loading
  • [1]
    NGUYEN DL, JURAN BD, LAZARIDIS KN. Primary biliary cirrhosis[J]. Best Pract Res Clin Gastroenterol, 2010, 24( 5): 647- 654. DOI: 10.1016/j.bpg.2010.07.006.
    [2]
    TANAKA A, LEUNG PS, GERSHWIN ME. Environmental basis of primary biliary cholangitis[J]. Exp Biol Med(Maywood), 2018, 243( 2): 184- 189. DOI: 10.1177/1535370217748893.
    [3]
    CHENG TC, LIU YC, XUE H, et al. Clinical manifestations and biochemical indexes of patients with primary biliary cholangitis with negative anti-mitochondria antibody M2 subtype[J]. J Nantong Univ Med Sci, 2022, 42( 6): 508- 512. DOI: 10.16424/j.cnki.cn32-1807/r.2022.06.003.

    程苕莼, 刘一村, 薛红, 等. 抗线粒体抗体M2亚型阴性原发性胆汁性胆管炎的临床表现与生化指标分析[J]. 南通大学学报(医学版), 2022, 42( 6): 508- 512. DOI: 10.16424/j.cnki.cn32-1807/r.2022.06.003.
    [4]
    LINDOR KD, BOWLUS CL, BOYER J, et al. Primary biliary cholangitis: 2018 practice guidance from the American association for the study of liver diseases[J]. Hepatology, 2018, 69( 1): 394- 419. DOI: 10.1002/hep.30145.
    [5]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of primary biliary cholangitis(2021)[J]. J Clin Hepatol, 2022, 38( 1): 35- 41. http://dx.doi.org/10.3969/j.issn.1001-5256.2022.01.007. DOI: 10.3969/j.issn.1001-5256.2022.01.007

    中华医学会肝病学分会. 原发性胆汁性胆管炎的诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38( 1): 35- 41. http://dx.doi.org/10.3969/j.issn.1001-5256.2022.01.007. DOI: 10.3969/j.issn.1001-5256.2022.01.007
    [6]
    CHEN HH, YOU DF, JIU L, et al. Comparison and application of matching in propensity score method and mahalanobis distance method[J]. Chin J Health Stat, 2017, 34( 6): 857- 860, 865.

    陈会会, 尤东方, 酒励, 等. 倾向性评分法和马氏距离法在匹配中的比较与应用[J]. 中国卫生统计, 2017, 34( 6): 857- 860, 865.
    [7]
    ZHANG FK, JIA JD, WANG BE, et al. Clinical characteristics of primary biliary cirrhosis: A report of 45 cases[J]. Chin J Intern Med, 2002, 41( 3): 163- 167.

    张福奎, 贾继东, 王宝恩, 等. 45例原发性胆汁性肝硬化的临床特征[J]. 中华内科杂志, 2002, 41( 3): 163- 167.
    [8]
    DONALDSON P, AGARWAL K, CRAGGS A, et al. HLA and interleukin 1 gene polymorphisms in primary biliary cirrhosis: Associations with disease progression and disease susceptibility[J]. Gut, 2001, 48( 3): 397- 402. DOI: 10.1136/gut.48.3.397.
    [9]
    LI CP, HWANG SJ, CHAN CY, et al. Clinical evaluation of primary biliary cirrhosis in Chinese patients without serum anti-mitochondrial antibody[J]. Zhonghua Yi Xue Za Zhi(Taipei), 1997, 59( 6): 334- 340.
    [10]
    LIU HL. Comparison of clinical and pathological characteristics between negative and positive anti-mitochondrial antibodies in patients with primary biliary cholangitis[D]. Nanjing: Southeast University, 2019.

    刘红丽. 抗线粒体抗体阴性和阳性的原发性胆汁性胆管炎患者临床及病理特征比较[D]. 南京: 东南大学, 2019.
    [11]
    TANAKA A, LEUNG PSC, GERSHWIN ME. Pathogen infections and primary biliary cholangitis[J]. Clin Exp Immunol, 2019, 195( 1): 25- 34. DOI: 10.1111/cei.13198.
    [12]
    FANG JY, ZHU ZP, LI K, et al. Study on the expression of PDC-E2 antibody in autoimmune liver diseases[J]. Chin Hepatol, 2017, 22( 1): 34- 37. DOI: 10.14000/j.cnki.issn.1008-1704.2017.01.012.

    方静怡, 朱正鹏, 李凯, 等. PDC-E2抗体在自身免疫性肝病的表达研究[J]. 肝脏, 2017, 22( 1): 34- 37. DOI: 10.14000/j.cnki.issn.1008-1704.2017.01.012.
    [13]
    LIU HY, ZHANG J, DENG AM, et al. Functional analysis of HLA-A*0201-restricted PDC-E2 specific CTLs in primary biliary cirrhosis[J]. Chin J Immunol, 2007, 23( 6): 555- 558.

    刘海英, 张建, 邓安梅, 等. 原发性胆汁性肝硬化HLA-A*0201限制性PDC-E2特异性CTL功能分析[J]. 中国免疫学杂志, 2007, 23( 6): 555- 558.
    [14]
    HUANG PJ, PAN ZF, SU HK. Prognostic vale of CRP/ALB ratio and NLR in cervical squamous cell carcinoma[J]. Transl Med J, 2019, 8( 2): 85- 88. DOI: 10.3969/j.issn.2095-3097.2019.02.005.

    黄培坚, 潘志锋, 苏鸿凯. 联合CRP/ALB比值和NLR对宫颈鳞状细胞癌预后的评估价值[J]. 转化医学杂志, 2019, 8( 2): 85- 88. DOI: 10.3969/j.issn.2095-3097.2019.02.005.
    [15]
    ZHOU HY, ZHOU CW. Research progress on serum globulin, cholinesterase and their ratios and evaluation of liver reserve function in liver cirrhosis[J]. Chin J Clin Gastroenterol, 2019, 31( 4): 267- 270. DOI: 10.3870/lcxh.j.issn.1005-541X.2019.04.20.

    周红宇, 周昌文. 血清球蛋白、胆碱酯酶及其比值与肝硬化肝脏储备功能评估的研究进展[J]. 临床消化病杂志, 2019, 31( 4): 267- 270. DOI: 10.3870/lcxh.j.issn.1005-541X.2019.04.20.
    [16]
    GONG YW. Interpretation of common liver function test indexes[J]. Sci Technol Fam, 2023, 5: 54- 55. DOI: 10.3969/j.issn.1005-7293.2023.05.025.

    龚彦文. 常见肝功能检验指标的解读[J]. 家庭科技, 2023, 5: 54- 55. DOI: 10.3969/j.issn.1005-7293.2023.05.025.
    [17]
    ZHOU JL, HUANG JQ, HE B, et al. A contrastive research of A/G ratio and anterior width of right branch of protal vein in the diagnosis of hepatic fibrosis[J]. Chin Gen Pract, 2017, 20( S2): 9- 12.

    周家龙, 黄建强, 何波, 等. 白球比、门脉右支前间隙对肝纤维化的诊断对比研究[J]. 中国全科医学, 2017, 20( S2): 9- 12.
    [18]
    LIAO YY, TENG CL, PENG NF, et al. Serum prealbumin is negatively associated with survival in hepatocellular carcinoma patients after hepatic resection[J]. J Cancer, 2019, 10( 13): 3006- 3011. DOI: 10.7150/jca.30903.
    [19]
    SONG SJ, SU GH. Application of serum total bile acid, cholinesterase and prealbumin detection in the diagnosis of liver disease[J]. J Med Inf, 2021, 34( 23): 9- 11. DOI: 10.3969/j.issn.1006-1959.2021.23.002.

    宋少娟, 苏国华. 血清总胆汁酸、胆碱酯酶和前白蛋白检测在肝病诊断中应用探析[J]. 医学信息, 2021, 34( 23): 9- 11. DOI: 10.3969/j.issn.1006-1959.2021.23.002.
    [20]
    HUANG F, GAO J. Modified Child-Pugh grade vs albumin-bilirubin grade for predicting prognosis of hepatocellular carcinoma patients after hepatectomy[J]. World J Gastroenterol, 2020, 26( 7): 749- 758. DOI: 10.3748/wjg.v26.i7.749.
    [21]
    WEI LY, ZHAI YZ, FENG GH. New advances in the use of serum prealbumin as an index of liver function[J]. World Chin J Dig, 2013, 21( 15): 1387- 1393.

    韦丽娅, 翟永贞, 冯国和. 血清前白蛋白对肝功能评估的研究进展[J]. 世界华人消化杂志, 2013, 21( 15): 1387- 1393.
    [22]
    COLLEN D, TYTGAT GN, CLAEYS H, et al. Metabolism and distribution of fibrinogen. I. Fibrinogen turnover in physiological conditions in humans[J]. Br J Haematol, 1972, 22( 6): 681- 700. DOI: 10.1111/j.1365-2141.1972.tb05715.x.
    [23]
    XU CH, WU LF, CHEN H. Value analysis of prothrombin time combined with platelet parameters and fibrinogen detection in the diagnosis of liver cirrhosis[J]. Mod Diagn Treat, 2022, 33( 14): 2125- 2127, 2130.

    许才红, 吴路发, 陈华. 凝血酶原时间联合血小板参数及纤维蛋白原检测在肝硬化诊断中的价值分析[J]. 现代诊断与治疗, 2022, 33( 14): 2125- 2127, 2130.
    [24]
    HU X, CHENG C, FENG LM. Changes in the levels of D-dimer and CoagulationFactor in patients with liver cirrhosis[J]. J Mod Lab Med, 2013, 28( 2): 60- 62. DOI: 10.3969/j.issn.1671-7414.2013.02.017.

    胡晓, 程超, 冯立民. 乙型肝炎后肝硬化患者凝血功能和血浆D-二聚体水平与Child-Pugh肝功能分级的关系分析[J]. 现代检验医学杂志, 2013, 28( 2): 60- 62. DOI: 10.3969/j.issn.1671-7414.2013.02.017.
    [25]
    BUDNICK IM, DAVIS JPE, SUNDARARAGHAVAN A, et al. Transfusion with cryoprecipitate for very low fibrinogen levels does not affect bleeding or survival in critically ill cirrhosis patients[J]. Thromb Haemost, 2021, 121( 10): 1317- 1325. DOI: 10.1055/a-1355-3716.
    [26]
    PECHLIVANI N, KEARNEY KJ, AJJAN RA. Fibrinogen and antifibrinolytic proteins: Interactions and future therapeutics[J]. Int J Mol Sci, 2021, 22( 22): 12537. DOI: 10.3390/ijms222212537.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(6)

    Article Metrics

    Article views (178) PDF downloads(36) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return