Clinical characteristics of decompensated primary biliary cirrhosis

Objective To study the clinical characteristics of decompensated primary biliary cirrhosis(PBC).Methods The clinical characteristics including demographics,laboratory tests,clinical manifestations,complications as well as scores of several prognostic models of 204 patients with PBC(113 patients with compensated cirrhosis and 91 patients with decompensated cirrhosis) were retrospectively studied.Then compared the clinical characteristics with 51 patients from decompensated hepatitis B(HBV group),20 patients from hepatitis C(HCV group) and 51 patients from decompensated alcoholic liver disease(ALD group).Results(1) The patients with decompensated PBC were older than those with compensated PBC and had significantly decreased blood cell counts,serum lipids,albumin and cholinesterase levels while increased international normalized ratio(INR),total bilirubin level and direct bilirubin level.The model integration of Child-Pugh grading,model of end-stage liver disease(MELD) and Mayo significantly increased(P0.05).(2) The patients with decompensated PBC were in mostly middle aged to elderly women and had higher serum alkaline phosphatase while the prothrombin time was shortened compared with those in HBV,HCV and ALD group.They had higher incidence of pruritus(compared with those in HCV and ALD group,P0.05),upper gastrointestinal bleeding(compared with those in HBV and HCV group,P0.05),more frequent complications with Sjogren's syndrome and osteoporosis and lower incidence of hepatocellular carcinoma.Conclusion PBC primarily affected middle aged to elderly women and the decompensated cirrhotic patients had significantly special clinical characteristics compared with those from other etiologies.