Retrospective study and meta-analysis:the clinical features of patients with primary biliary cirrhosis in recent 20 years in China / 中华风湿病学杂志

ABSTRACT

ObjectiveTo investigate the clinical features of patients with primary biliary cirrhosis (PBC) in China. MethodsThe reported articles about clinical analysis of patients with PBC in China were searched. The quality of included studies was critically evaluated. Meta-analysis was performed using RevMan 4.2 software about controlled trials. Results① Ninety-one literatures including 2315 patients wuth PBC were included. ②The common symptoms in PBC were fatigue (54.54％). AMA was found in 74.1％～100％ of patients with PBC, as well as the prevalence rate of anti-M2 range from 45％ to 83％. ANA antibodies present in 20％～83.78％ of patients, the most common antinuclear patterns were nuclear-envelope(38.65％).Increased levels of IgM [(2.8±0.7)～(7.3±5.1) g/L], IgG [(16.5±4.9)～(20.5±5.9) g/L] were found in these patients, and the most common liver histologic classification was type Ⅱ (36.6％). Sjogren's syndrome occured significantly more frequently in PBC (1.96％～34.61％). To the end of follow-up period (five months to nintysix months ), 3.80％ of patients were dead. ③ Meta-analysis performed in several case control studies, showed no significant differences was found in liver tests including of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotrans ferase (AST), total bilirubin (TBil), or gamma-glutamyltransferase (GGT), IgG levels between AMA positive groups and AMA negative groups. However, lower levels of IgM presented in the latter. While it also showed that levels of ALP decreased after ursodeoxycholic acid (UDCA)therapy. The levels of TBil were lower in the elderly than in younger group, but the mortality ratio for liver diseases was higher in the former. ConclusionThe clinical characteristics of the present series in China are mostly similar to those reported in other countries. Because of the low quality and the small number of included studies, larger sample-size, randomized, double-blinded controlled trials are needed.