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目的探讨生育因素在原发性胆汁性胆管炎(PBC)发病中的作用。方法收集2013年10月-2015年8月就诊于西京医院并明确诊断的273名PBC女性患者。排除合并自身免疫性肝炎、原发性硬化性胆管炎重叠综合征、肝性脑病及经电话回访后资料不全的患者,共纳入有女性亲属配比的54名女性PBC患者(PBC组)加入本次调查研究。同一时间段收集与PBC患者在10岁年龄段内的女性亲属,排除合并其他系统严重疾病及经电话回访资料不全者,共纳入88名参与者(亲属组)。对所有入选者采用PBC女性生育因素调查表进行问卷调查,收集数据。计量资料2组间比较采用独立样本的t检验,计数资料组间比较采用χ2检验,剂量-反应关系采用多因素Logistic回归分析。结果 PBC组平均生育次数显著大于亲属组(2.55±1.84 vs 1.84±0.95;t=2.708,P=0.009)。对2组生育次数进行剂量-反应关系连续变量统计分析提示,生育次数与PBC发病呈剂量-反应关系(P=0.002)。结论生育次数可能是PBC发病的相关因素,通过剂量-反应关系参与PBC发病。对于PBC易感性的女性,减少生育次数可能会降低其发生PBC的概率。
Objective To investigate the role of fertility in the pathogenesis of primary biliary cholangitis (PBC). Methods A total of 273 female patients with PBC who were diagnosed at Xijing Hospital from October 2013 to August 2015 were collected. Excluding patients with autoimmune hepatitis, primary sclerosing cholangitis overlap syndrome, hepatic encephalopathy and incomplete data after telephone interview, 54 female PBC patients (PBC group) with female relatives were enrolled in this study Secondary investigation. A total of 88 participants (relatives) were enrolled in the same period of time with female relatives of PBC patients within the 10-year age range, excluding those with other serious systemic diseases and those who had undergone telephone referrals. All participants were surveyed using the PBC Female Fertility Factor Survey to collect data. Measurement data were compared between two groups using independent samples t test, count data were compared using the χ2 test, dose-response relationship using multivariate Logistic regression analysis. Results The average number of births in PBC group was significantly larger than that in relatives group (2.55 ± 1.84 vs 1.84 ± 0.95; t = 2.708, P = 0.009). The statistical analysis of continuous variables of dose-response relationship between the two groups showed that the number of births was dose-response relationship with the incidence of PBC (P = 0.002). Conclusion The number of births may be related to the incidence of PBC, P dose-response relationship in the pathogenesis of PBC. For women with PBC susceptibility, reducing the number of births may reduce their probability of developing PBC.