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논문 기본 정보

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저자정보
Hu Yi-Fan (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Li Shun-Xin (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Liu Hong-Li (Department of Second Clinical Medical College, Southeast University School of Medicine, Nanjing, China) Du Zhi-Xiang (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Wang Shuang-Shuang (Department of School of Public Health, Nanjing Medical University, Nanjing, China) Chen Miao-Yang (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Wang Li (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Xiong Qing-Fang (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Zhong Yan-Dan (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Liu Du-Xian (Department of Pathology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China) Yang Yong-Feng (Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver Vol.18 No.5
발행연도
2024.9
수록면
867 - 876 (10page)
DOI
10.5009/gnl230468

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Background/Aims: The histological characteristics and natural history of precirrhotic primary biliary cholangitis (PBC) with portal hypertension (PH) are unclear. Our aim was to clarify the prevalence, risk factors, and histological characteristics of precirrhotic PBC patients with PH. Methods: This retrospective study compared the clinical features, histological characteristics, and response to ursodeoxycholic acid (UDCA) between the PH and non-PH groups of precirrhotic PBC patients. Results: Out of 165 precirrhotic PBC patients, 40 (24.2%) also had PH. According to histological stage 1, 2 and 3 disease, 5.3% (1/19), 17.3% (17/98), and 45.8% (22/48) of patients also had PH, respectively. Precirrhotic PBC with PH was significantly positively correlated with bile duct loss, degree of cytokeratin 7 positivity, and degree of fibrosis in the portal area, but significantly negatively correlated with lymphoid follicular aggregation. Compared to the non-PH group, patients in the PH group showed a higher prevalence of obliterative portal venopathy, incomplete septal fibrosis, portal tract abnormalities and non-zonal sinusoidal dilatation (p<0.05). In addition, patients with PH were more likely to present with symptoms of jaundice, ascites, epigastric discomfort, a poorer response to UDCA, and more decompensation events (p<0.05). High alkaline phosphatase levels, low white blood cell counts, high Mayo scores, and high FIB-4 index values were risk factors for precirrhotic PBC with PH. Conclusions: Approximately 24.2% of precirrhotic PBC patients have PH, which is histologically related to the injury of bile ducts. High alkaline phosphatase levels, low white blood cell counts, high Mayo scores, and high FIB-4 index values are associated with increased risk of precirrhotic PBC with PH.
#Primary biliary cholangitis #Portal hypertension #Histology #Cholestasis #Early disease

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