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題 名 | Primary Biliary Cirrhosis in Antimitochondrial Antibody-Negative Patients: Chang Gung Memorial Hospital Experience=抗粒線體抗體陰性之原發膽道性肝硬化--長庚紀念醫院之經驗 |
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作 者 | 鄒永寬; 葉昭廷; | 書刊名 | 長庚醫學 |
卷 期 | 26:5 2003.05[民92.05] |
頁 次 | 頁323-329 |
分類號 | 415.534 |
關鍵詞 | 原發膽道性肝硬化; 抗粒線體抗體; 抗核抗體; Primary biliary cirrhosis; Antimitochondrial antibody; Antinuclear antibody; |
語 文 | 英文(English) |
中文摘要 | 背景:雖然部分患者在臨床,組織學及實驗室檢查方面具有原發膽道性肝硬化的特徵但是卻缺乏血清抗粒線體抗體。在亞洲國家,關於抗粒線體抗體陰性之原發膽道性肝硬化的臨床資料仍相當有限。因此於本研究報告中,我們檢視本院抗粒線體抗體陰性之原發膽道性肝硬化患者的資料以期對此情況有更進一步的了解。 方法:自西元1985年至2000年,在林口長庚醫院共有36位患者經病理診斷為原發膽道性肝硬化。其中15例第一次檢驗其血清抗粒線體抗體呈陰性,另21例則為陽性。我們分析比較血清抗粒線體抗體陰性和陽性這兩組病患的臨床表現,肝生化指數,血清免疫標記,和組織學特徵的異同。 結果:抗粒線體抗體陰性和陽性兩組原發膽道性肝硬化患者只存在著些許不同。與抗粒線體抗體陽性患者比較,抗粒線體抗體陰性組明顯有較多的無症狀患者(p=0.0017),較高的血清抗核抗體陽性率(p=0.0323)。除此之外,其它的臨床表現,肝生化指數,血清免疫標記,和組織學特徵並無有意義的差別。值得注意的是,15位抗粒線體抗體陰性患者中有4位在追蹤10, 23, 47以及56月(平均34月)時其血清抗粒線體抗體轉為陽性。 結論:抗粒線體抗體陰性之原發膽道性肝硬化患者傾向於較無症狀,且血清抗核抗體呈陽性。部分患者於後續追蹤時其血清抗粒線體抗體可轉為陽性。我們的資料暗示著抗粒線體抗體陰性原發膽道性肝硬化是抗粒線體抗體陽性之原發膽道性肝硬化的一種變異,而非另一種不同的疾病。 |
英文摘要 | Background: It is known that some patients with clinical, histological, and laboratory features of primary biliary cirrhosis (PBC) lack serum antimitochondrial antibodies (AMAs). In Asian countries, clinical information regarding AMA-negative PBC is still limited. In this report, we reviewed our patients with AMA-negative PBC in order to further understand this disease. Methods: Clinical features of 36 patients with PBC diagnosed by the histopathologic characteristics of the liver at Chung Gung Memorial Hospital—Lin Kou Medical Center from 1985 to 2000 were reviewed. Of them, 15 were negative and 21were positive for serum AMAs at presentation. Clinical, biochemical, immunological, and histological parameters were compared between these 2 groups. Results: There were only a few differences between the AMA-negative and –positive groups. Significantly more asymptomatic patients (p=0.0017) and a higher positive rate of serum antinuclear antibodies (ANA) (p=0.0323) were observed in the AMA-negative group. Otherwise, there were no significant differences with regard to clinical, biochemical, immunological, or histological parameters. Interestingly, 4 of the 15 patients with AMA-negative PBC became AMA positive during 10, 23, 47 and 56 (mean, 34) months of follow-up. Conclusions: The results show that patients with AMA-negative PBC tend to be asymptomatic and ANA positive. Some patients may develop positive AMA during follow-up. Our data imply that AMA-negative PBC might be a variant of AMA-positive PBC, rather than a separate disease. |
本系統中英文摘要資訊取自各篇刊載內容。