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Abstract
Background. The disease progression of patients with primary biliary cirrhosis (PBC) varies significantly, and the prognostic markers that identify those patients who will develop liver failure have been scarcely studied from a Chinese cohort.
Aims. We aimed to determine the predictive factors of liver failure in patients with PBC.
Methods. Patients who were first diagnosed as PBC with hepatic compensation between January 2007 and December 2009 were enrolled in this cohort study.
Results. Altogether 398 patients were finally included. Of these patients, 80% were women, 98% had positive antimitochondrial antibodies, and 45% had positive antinuclear antibodies (ANA). To December 2012, a total of 38 patients developed liver failure. According to the outcome, patients who developed liver failure had had higher serum concentration of baseline total bilirubin (TBil) (p = 0.013) and total bile acid (TBA) (p < 0.001), and lower concentrations of baseline total cholesterol (Tch) (p = 0.008), than patients who did not develop liver failure. Additionally, the proportion of ANA positivity was statistically different between the two groups (p = 0.009). In the established model for predicting liver failure in PBC, three variables were finally selected out, including Tch (odds ratio (OR) 0.552, 95% confidence interval (CI) 0.394–0.774, p < 0.001), TBA (OR 1.006, 95% CI 1.002–1.010, p = 0.002), and ANA (+ versus –, OR 5.518, 95% CI 1.155–26.376, p = 0.032).
Conclusions. ANA, Tch, and TBA are predictors of liver failure in PBC.
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Details
1 1 Clinical Trial Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China; 8 Liver Failure Therapy and Research Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China
2 2 Postgraduate Division, Academy of Military Medical Science, Beijing 100850, China
3 3 Radiology Department, PLA General Hospital, Beijing 100853, China
4 4 Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
5 5 Medical Information Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China
6 6 Clinical Laboratory, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China
7 7 Ultrasonography Department, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China
8 8 Liver Failure Therapy and Research Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China
9 1 Clinical Trial Center, Beijing 302 Hospital (PLA 302 Hospital), Beijing 100039, China