关键词: 原发性胆汁性胆管炎, 抗糖蛋白210抗体, 熊去氧胆酸, 临床特征, 治疗

Abstract: Objective The purpose of this study was to investigate the clinical feature of primary biliary cholangitis (PBC) patients with serum anti glycoprotein (gp) 210 antibody positive. Methods 63 patients with PBC were encountered in our hospital between January 2017 and January 2021, and the diagnosis was made by serum anti mitochondrial antibody (AMA)/AMA-M2 (control) or serum anti-gp 210 (observation) positive. The ursodeoxycholic acid (UDCA) regimen was given to all the patients in the two groups. Serum cytokines and immunoglobulin levels were routinely assayed. Results There were no significant differences as respect to age and gender between the two groups (P>0.05), while the incidence of fatigue in the observation group was 47.6%, much higher than 35.7% (P<0.05) in the control; at admission, serum bilirubin, ALT and AST levels in the observation group were 30.1(18.5, 66.1)μmol/L, 73(42, 110)U/L and 87(64, 126)U/L, all significantly higher than [20.1(10.4, 31.5)μmol/L, 53(27,90)U/L and 68(53, 101)U/L, P<0.05], while serum albumin (Alb) level was 32.2(29.8, 35.2)g/L, significantly lower than [34.6(30.4, 36.8)g/L, P<0.05] in the control; after six month treatment, serum Alb level in the observation was 37.8(35.4, 38.5)g/L, still much lower than [42.3(37.4, 45.1)g/L, P<0.05] in the control; before treatment, serum IL-6 and IL-10 levels in the observation were 12.7(5.8, 11.3)pg/ml and 125.1(87.4, 120.6)pg/ml, both significantly higher than [9.1(7.0, 11.7)pg/ml and 103.6(90.1, 117.0)pg/ml, P<0.05] in the control; at the end of six month treatment, serum IL-2 and IL-6 levels in the observation were 29.1(18.4, 36.5)pg/ml and 7.2(5.2, 8.5)pg/ml, both significantly higher than [21.0(9.7, 26.3)pg/ml and 5.4(4.0, 6.9)pg/ml, P<0.05] in the control, while serum IL-10 level was 139.5(107.6, 152.9)pg/ml, much lower than [154.8(122.7, 168.2)pg/ml, P<0.05] in the control; six months after treatment, serumIgM, IgG and IgA levels in the observation were 3.1(2.5, 3.7)g/L, 13.7(12.0, 14.6)g/L and 3.8(2.9, 3.8)g/L, all significantly higher than [2.2(1.9, 2.6)g/L, 11.2(10.1, 13.4)g/L and 2.8(2.5, 3.3)g/L, respectively, P<0.05] in the control group. Conclusion The PBC patients with serum anti-gp210 antibody positive seems clinically severe and less or relatively slowly respond to UDCA treatment, which needs further multicenter investigation.

Key words: Primary biliary cholangitis, Anti-glycoprotein 210 antibody, Clinical features, Ursodeoxycholic acid, Therapy