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吴学芬.熊去氧胆酸疗效评分可有效预测原发性胆汁性胆管炎患者对熊去氧胆酸的治疗反应[J].内科急危重症杂志,2025,31(3):215-219
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| DOI：10.11768/nkjwzzzz20250304 |
| 中文关键词: 原发性胆汁性胆管炎 自身免疫性肝病 危险因素 熊去氧胆酸 治疗反应 |
| 英文关键词: |
| 基金项目:国家自然科学基金资助项目(82271847);湖北陈孝平科技发展基金会(CXPJJH11800005-07);华中科技大学第二临床学院教学研究基金（TJJXYJ2023045） |
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| 中文摘要: |
| 摘要 目的：探讨原发性胆汁性胆管炎（PBC）患者中对熊去氧胆酸（UDCA）治疗反应欠佳的相关独立危险因素，并在PBC患者中验证UDCA疗效评分(URS)的预测效能。方法：纳入接受UDCA治疗且随访时间至少12个月的PBC患者，计算基线URS。采用Logistic回归模型确定对UDCA治疗反应欠佳的独立危险因素。结果：在194例UDCA治疗的PBC患者(中位年龄52.0岁，男10.3%，女89.7%)中，136例(70.1%)患者治疗有效。合并食管胃底静脉曲张和基线碱性磷酸酶（ALP）升高是UDCA疗效不佳的独立危险因素。URS预测PBC患者UDCA单药和联合治疗预后的受试者操作特征曲线下面积（AUC）分别为0.859和0.910。抗线粒体抗体(AMA)和抗gp210抗体阴性的PBC患者AUC高于AMA和抗gp210抗体阳性患者。结论：URS对新诊断的PBC患者UDCA治疗有效性上具有良好的预测价值，尤其在抗体阴性的亚组中。 |
| 英文摘要: |
| Abstract Objective: To identify the related independent risk factors of inadequate response to ursodeoxycholic acid (UDCA) and to validate the UDCA response score in a cohort of Chinese primary biliary cholangitis (PBC) patients. Method: PBC patients who initiated UDCA treatment and had at least 12 months of follow-up data were included. Baseline UDCA response score was calculated. Logistic regression models were performed to identify the independent risk factors of incomplete biochemical response to UDCA. Results: Among the 194 UDCA-treated PBC patients (mean age 52.0 years, males 10.3%, females 89.7%), 136 (70.1%) patients showed a response. The combination with esophagogastric varices and elevated baseline alkaline phosphatase (ALP) were the independent risk factors of suboptimal response to UDCA. The AUC was 0.859 for treatment response of UDCA monotherapy, and 0.910 for PBC patients receiving combination therapy. As for PBC patients with negative anti-mitochondrial antibody (AMA) and anti-GP210 antibody, the AUC was greater than that with positive AMA and anti-GP210 antibody. Conclusion: Our results demonstrated that the UDCA response score had good predictive value in newly diagnosed Chinese PBC patients, especially in antibody-negative subgroups. |
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