Abstract: Objective The aim of this study was to summarize the efficacy of ursodeoxycholic acid (UDCA) in the treatment of patients with primary biliary cholangitis (PBC) and cirrhosis and its effect on serum nuclear factor-related factor 2 (Nrf2) and hemeoxygenase-1 (HO-1) levels. Methods 31 patients with PBC and 34 patients with primary biliary cirrhosis (Child A in 15, Child B in 12 and Child C in 7 cases) were recruited in our hospital between January 2017 and January 2020, and 43 healthy persons were selected as control group. The patients with cholangitis and cirrhosis were all treated with UDCA for 12 months. Serum malondialdehyde (MDA), superoxide dismutase (SOD), Nrf2 and HO-1 levels were detected. Results At presentation, serum GGT and ALP levels in patients with primary biliary cirrhosis were (389.4±29.7)U/L and (457.9±73.8)U/L, both significantly higher than [(173.5±16.4)U/L and (298.3±52.1)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; at the end of 12 month treatment, serum GGT and ALP levels in patients with primary biliary cirrhosis were(174.1±10.4)U/L and (144.6±24.5)U/L, still significantly higher than [(72.6±7.1)U/L and (95.7±11.6)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; serum Nrf2, HO-1, MDA and SOD levels in healthy individuals were (182.3±30.6)U/L, (12.2±2.1)U/L, (4.1±0.7)mol/L and (102.3±17.8)U/mL; at 12 month observation, serum Nrf2, HO-1 and MDA levels in patients with primary biliary cirrhosis were (712.6±100.1)U/L, (25.1±4.3)U/L and (7.6±1.3)mol/L, all significantly higher than [(665.3±90.5)U/L, (21.3±3.8)U/L and (6.5±1.1)mol/L, respectively, P<0.05], while serum SOD level was (80.6±14.5)U/mL, significantly lower than [(90.8±15.6)U/mL, P<0.05] in patients with primary biliary cholangitis; there were no significant differences as respect to serum Nrf2, HO-1, MDA and SOD levels in cirrhotics with Child class A, B and C(P＞0.05). Conclusion The continuous administration of UDCA could improve the liver function test normalization in patients with PCB and cirrhosis, which might be related to the amelioration of cholestasis, inhibition of oxidative stress, and increase serum Nrf2 and HO-1 levels.

Key words: Primary biliary cholangitis, Liver cirrhosis, Ursodeoxycholic acid, Nuclear factor related factor 2, Heme oxygenase-1, Therapy