抗线粒体抗体阳性患者首次就诊情况分析

摘要

Objective To understand the basic information of anti-mitochondrial antibody (anti-AMA)-positive patients after initial diagnosis,and to set groundwork for further exploring the clinical significance of AMA in various diseases.Methods Demographic data and related clinical information recorded through the Information System of Peking University People's Hospital from January 2013 to December 2016 were collected.Patients whose AMA and/or AMA-M2 first-tested as positive were recorded.Complications were classified according to the Intemational Classification of Diseases.Results A total of 1323 AMA positive cases were discovered for the first time.Among them,78.0％ were women,and the age of initial diagnosis was 56.8 ± 16.0 years.The first three initially diagnosed departments were rheumatology and immunology (37.4％),liver Disease (15.9％) and hematology (15.9％) relevant to musculoskeletal and connective tissue diseases (45.2％),hematology and hematopoietic organs and immune diseases (30.6％) and circulatory system diseases (29.7％).There were 297 newly confirmed cases of primary biliary cholangitis (PBC);accounting for 89.2％ of women,and the age of initial diagnosis was 60.1 ± 12.4 years.The top three departments of initially diagnosed as PBC were liver disease (37.7％),rheumatology (33.0％) and gastroenterology (15.2％),of which 39.7％ had musculoskeletal and connective tissue diseases,27.9％ had circulatory diseases,and 24.9 ％ were combined with endocrine and metabolic diseases.Conclusion Besides PBC and other autoimmune diseases,AMA and / or AMA-M2 positivity can be observed in a variety of diseases in several clinical departments,and its clinical significance remains to be further clarified.%目的 了解抗线粒体抗体(AMA)阳性患者首诊的基本情况,为进一步探讨AMA在各种疾病中的临床意义奠定基础.方法 通过北京大学人民医院信息系统,收集2013年1月-2016年12月首次检测AMA和/或AMA-M2阳性的患者,记录其人口学资料和相关临床信息.合并症依据国际疾病编码分类.结果 共收集首次发现AMA阳性者1 323例,其中女性占78.0％,首诊年龄(56.8±16.0)岁.首诊科室前三位依次是风湿免疫科(37.4％)、肝病科(15.9％)和血液科(15.9％);涉及肌肉骨骼和结缔组织疾病(45.2％)、血液和造血器官及免疫疾病(30.6％)和循环系统疾病(29.7％)等.新确诊原发性胆汁性胆管炎(PBC)297例,女性占89.2％,首诊年龄(60.1±12.4)岁.PBC首诊科室前三位依次是肝病科(37.7％)、风湿免疫科(33.0％)和消化科(15.2％),其中39.7％合并肌肉骨骼和结缔组织病、27.9％合并循环系统疾病、24.9％合并内分泌和代谢疾病. 结论 除PBC和其他自身免疫性疾病外,AMA和/或AMA-M2阳性还可见于多个临床科室的多种疾病,其临床意义有待进一步明确.