摘要
目的探讨早期预测熊去氧胆酸(UDCA)治疗原发性胆汁性肝硬化(PBC)患者疗效的方法。方法回顾性分析26例PBC患者的临床资料,他们接受常规剂量的UDCA治疗,分别在3个月、6个月和9个月观察疗效,以血清ALP降低>40%为应答标准,采用受试者工作特征(ROC)曲线下面积和Bland-Altman图分析一致性来预测1年时的疗效。结果本组患者治疗3个月应答者9例(34.6%),6个月应答者9例(34.6%),9个月应答者14例(53.8%),1年应答者15例(57.7%);3个月内应答者ROC曲线下面积(0.83,p=0.004,95%CI 0.66～1.01)能较好判断患者1年的疗效,Bland-Altman一致性分析发现3个月应答者和12个月应答者ALP降低百分比的差值较好地分布在95%一致性界限内;3个月应答者与不应答者的年龄和入组时生化指标间无显著性差异。结论 PBC患者服用UDCA 3个月时血清ALP的下降水平可判断1年后的疗效。
Objective To early predict the efficacy of ursodeoxycholic acid （UDCA）in the treatment of pa- tients with primary biliary cirrhosis （PBC）. Methods Twenty-six patients with PBC were treated with UDCA at dose of 13-15mg.kg-1. d-1 for one year and the response at month three was retrospectively analyzed for the pre- diction of one-year efficacy. The serum ALP decrease greater than 40% acted as response. Results At the end of 1 year observation, the response rates were 35% in 3,35% in 6,54% in 9 and 58% in 12 months;the ROC curve showed 3-month response （0.83,P=0.004,95%CI 0.66-1.01）predicted the 1-year efficacy well,and the Bland-Ahman showed 3-month response was consistent with one-year＇s;there was no significant difference between 3-month responders and the non-responders as respect to age and blood biochemical parameters at baseline. Conclusion 3-month response can predict the efficacy of 1 year in patients with PBC receiving UDCA therapy.
出处
《实用肝脏病杂志》
CAS
2013年第2期108-110,共3页
Journal of Practical Hepatology
