A 10-year follow-up study of 171 cases of primary biliary cholangitis

SU Rong; MIAO Yu; MENG Xiang-kun; ZHANG Xiao-xu; YIN Hua; LIU Hao; LIN Wan; HUANG Ying; ZHANG Xu; YANG Shao-qi

doi:10.19538/j.nk2024100112

Abstract：Objective Follow-up data of patients with primary biliary cholangitis(PBC)for 10 years,summarize the clinical characteristics and analyze the survival,and explore the risk factors related to the prognosis of PBC.Methods On July 1st,2015,a total of 171 PBC patients who were first diagnosed in the General Hospital of Ningxia Medical University and the Cardiovascular and Cerebrovascular Hospital from 2008 to 2013 were retrospectively collected,and their files were established.After July 2015,the patients'previous medical information and prognosis were followed up,and the observation ended on July 31,2023.Observe the general data of patients,laboratory examination results,relevant imaging data and digestive endoscopy results.The survival rate was calculated by life table method,and the factors affecting prognosis were analyzed by Kaplan-Meier method.The univariate statistically significant variables were included in the multivariate Cox regression model analysis.Results The average age of 171 patients was(57.71±1 1.79)years,and the ratio of male to female was 1∶4.9.At the first visit,only 38.01％of patients were in the early stage of PBC,and 39.76％were complicated with autoimmune diseases.The average death age of PBC patients was(61.69±10.96)years,and the main causes of death were upper gastrointestinal bleeding(32.9％),abdominal infection(23.6％)and severe pneumonia(20.7％).The average survival time of PBC patients was 64.26 months,the 1-year survival rate was81.87％,the 3-year survival rate was 51.46％,the 5-year survival rate was 39.77％,and the 10-year survival rate was 20.75％.Multivariate COX regression analysis showed that delayed diagnosis(HR 68.035),poor or unresponsive ursodeoxycholic acid(HR 8.081)and serum calcium ion(HR 0.629)were independent risk factors affecting the overall survival time of patients.Delayed diagnosis(HR 83.302),fatigue(HR 2.668),combination with other immunosuppressive drugs(HR 1.733),platelet(HR 0.997)and weight maintenance(HR 0.189)are independent risk factors for complications.Poor or unresponsive ursodeoxycholic acid(HR 4.204),fatigue(HR 1.721)and platelet(HR 0.997)are independent risk factors that affect the imaging progress of patients.Conclusion PBC is more common in middle-aged women,and its early symptoms are not specific.40％patients are complicated with other autoimmune diseases.Gastrointestinal bleeding,abdominal infection and severe pneumonia are the leading causes of death.Delayed diagnosis,poor or unresponsive response of ursodeoxycholic acid and serum calcium ion ≤2.0mmol/L are independent risk factors affecting the overall survival time of patients.