合并中-重度界面炎显著增加原发性胆汁性胆管炎患者治疗不完全应答风险:一项回顾性队列研究*

doi:10.3969/j.issn.1672-5069.2026.04.014

摘要/Abstract

摘要： 目的探讨合并中-重度界面炎的原发性胆汁性胆管炎(PBC)患者临床特征,分析治疗不完全应答的影响因素。方法 2019年1月～2023年12月中国医科大学附属第一医院诊治的PBC患者271例,其中组织学检查提示存在中-重度界面炎者37例。接受常规熊去氧胆酸(UDCA)等治疗。采用多因素Logistic回归分析治疗1年不完全应答的影响因素。结果在治疗1年末,本组获得完全应答196例(72.3%);未完全应答组男性、血清抗gp210阳性和合并肝组织中-重度界面炎占比分别为24.0%、18.7%和28.0%,均显著高于完全应答组的6.6%、3.1%和8.2%(P<0.05);血清ALP、GGT、IgG和γ-球蛋白水平分别(297.6±3.5)U/L、(299.0±23.9)U/L、(16.2±1.5)g/L和(16.5±1.7)%,均显著高于完全应答组【分别为(50.5±5.8)U/L、(174.9±15.1)(U/L、(12.4±1.1)g/L和(8.8±2.0)%,P<0.05】;多因素Logistic回归分析显示,合并中-重度界面炎、高水平血清ALP和血清抗gp210阳性是PBC患者治疗1年不完全应答的独立影响因素(P<0.05)。结论接受UDCA治疗的PBC患者可能不能获得完全应答,其中未达到重叠综合征而合并肝组织中-重度界面炎可能是影响因素之一,应及时发现并给予相应的处理。

关键词: 原发性胆汁性胆管炎, 熊去氧胆酸, 中-重度界面炎, 治疗, 应答

Abstract: Objective The aim of this study was to analyze factors that impact response to ursodeoxycholic acid (UDCA) therapy in patients with primary biliary cholangitis(PBC). Methods A total of 271 patients with PBC were encountered in First Affiliated Hospital, China Medical University, between January 2019 and December 2023, all underwent liver biopsies, finding liver tissue moderate to severe interface inflammation in 37 cases. Patients received UDCA therapy. Multivariate Logistic regression analysis was applied to reveal independent impacting factors for poor response by end of 1 year of treatment. Results By end of one-year UDCA treatment, complete response (CR) was obtained in 196 cases(72.3%) in our series; percentages of male, serum anti-gp210 positive and liver tissue moderate to severe interface inflammation in patients without CR were 24.0%, 18.7% and 28.0%, all significantly higher than 6.6%, 3.1% and 8.2%(P<0.05) in those with CR; serum ALP, GGT, IgG and γ-globulin levels were (297.6±3.5)U/L, (299.0±23.9)U/L,(16.2±1.5)g/L and (16.5±1.7)%, all much higher than [(50.5±5.8)U/L, (174.9±15.1)U/L, (12.4±1.1)g/L and (8.8±2.0)%,respectively, P<0.05] in those with CR; multivariate Logistic regression analysis showed that liver tissue moderate to severe interface inflammation, high level of serum ALP and serum anti-gp210 positive were all the independent impacting factors for poor response to UDCA therapy (P<0.05). Conclusion Patients with PBC could not response to UDCA treatment completely, especially in those who didn’t meet criteria of overlapping syndrome but with liver tissue moderate to severe interface inflammation, which should be surveyed early and give them appropriate management.

Key words: Primary biliary cholangitis, Ursodeoxycholic acid, Moderate-to-severe interface inflammation, Treatment, Prognosis

冯岩, 张鑫赫, 李异玲. 合并中-重度界面炎显著增加原发性胆汁性胆管炎患者治疗不完全应答风险:一项回顾性队列研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 533-536.

Feng Yan, Zhang Xinhe, Li Yiling. Concomitant liver tissue moderate to severe interface inflammation might impact response to ursodeoxycholic acid therapy in patients with primary biliary cholangitis[J]. Journal of Practical Hepatology, 2026, 29(4): 533-536.

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合并中-重度界面炎显著增加原发性胆汁性胆管炎患者治疗不完全应答风险:一项回顾性队列研究^*

Concomitant liver tissue moderate to severe interface inflammation might impact response to ursodeoxycholic acid therapy in patients with primary biliary cholangitis

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