摘要

在1955年至1979年间斯德哥尔摩县溃疡性结肠炎(UC)发病率的流行病学研究中，发现了1274例UC患者。几乎所有这些患者都定期进行了肝功能检查;142例(11%)有肝胆疾病征象。1989 ~ 1991年，对142例肝功能异常合并UC患者进行随访研究，探讨肝脏异常的原因及肝脏疾病是否对生存率有影响。在随访时，8例患者被重新归类为克罗恩病，60例从检测结果判断肝功能正常，而其余74例仍有肝胆疾病的迹象。对肝功能短暂性异常最常见的解释是活动性结肠炎。肝损伤的暂时症状与这些患者的生存率变化无关。21例患者的肝功能异常是由感染引起的，特别是由输血传播的乙型和丙型肝炎病毒引起的感染，其中9例为慢性但非致命病程。29例(2.3%)患者发生原发性硬化性胆管炎(PSC)，其中12例在研究期间死亡，4例死于胆管癌，8例死于肝衰竭;一位病人接受了移植手术。 The estimated median time of survival from the first presentation of evidence of a liver function, compatible with the diagnosis of PSC, to death or liver transplantation was 21 years. A comparison of survival rates in patients with UC and patients with UC and concurrent PSC showed, a significant reduction in survival in the PSC group (p<0.0001). The number of patients with UC who developed PSC remained constant during the study period. Thus, although evidence of abnormal liver function is a common finding in UC, a spontaneous return to normal levels is common. In this study, which did not have a selection bias, the median time of survival among PSC patients was far longer than previously described although development of PSC among patients with UC does significantly reduce the estimated median time of survival.