Clinicopathological significance of ursodeoxycholic acid treatment for asymptomatic primary biliary cirrhosis: Comparison with its natural course.

概要

論文の詳細を見る
We studied the natural course of 31 patients with asymptomatic primary biliary cirrhosis (a-PBC) and also evaluated clinicopathological effects of ursodeoxycholic acid (UDCA) treatment on 16 cases out of them. No significant change of serum ALP, γ-GTP, ALT or IgM level was observed in the period before UDCA treatment, and four cases became symptomatic after a mean period of 19.5 months. After 600mg/day of UDCA administration, we found a significant decrease in serum ALP, γ-GTP, ALT and IgM levels. Histopathological findings of liver specimens in each patient were graded in 6 categories: lymphocytic piecemeal necrosis, cholestasis, disappearance of bile duct, bile duct inflammation, fibrosis and portal inflammation. Only the score of bile duct inflammation fell in the pretreatment period, while a significant improvement in scores of cholestasis, bile duct inflammation, fibrosis and portal inflammation was observed after UDCA treatment. These results strongly suggest that UDCA treatment for a-PBC is very effective in both clinical and pathological aspects.