[Baseline analysis of refractory primary biliary cirrhosis].

OBJECTIVE

To summarize the clinical characters of refractory primary biliary cirrhosis (PBC) versus typical ones and explore the risk factors of prognosis.

METHODS

From 2009 to 2011, 60 PBC patients on the therapy of ursodeoxycholic acid (UDCA) over 1 year at our clinic were recruited. According to the response to UDCA by the Paris criteria, they were divided into refractory group (n = 23) and typical group (n = 37) to analyze the basic clinical conditions, biochemical markers, antibodies and liver biopsies.

RESULTS

(1) Compared with the typical patients, the refractory ones had more fatigue (73.9% vs 45.9%), pruritus (60.9% vs 40.5%) and jaundice (43.4% vs 18.9%); (2) the serum level of biomarkers (alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), total bilirubin (TBIL), direct bilirubin (DBIL) and immunoglobulin M (IgM)) were higher in the refractory group (P < 0.05); (3) no differences existed between two groups in age, gender, antibodies (antinuclear antibody (ANA), antimitochondrial antibody (AMA), AMA-M2, anti-GP210, anti-SP100 and anti-centromere antibody (ACA)) or liver biopsies.

CONCLUSION

Some clinical severe manifestation (fatigue, pruritus and jaundice) and higher biochemical markers levels (ALT, AST, ALP, GGT, TBIL, DBIL and IgM) seem to predict a worse response to UDCA and a rapid progression of disease in PBC patients.