肝抗原自身抗体在自身免疫性肝病诊断中的意义

Significance of auto-antibody of liver antigens in diagnosis of autoimmune hepatic diseases

目的 探讨肝抗原自身抗体在自身免疫性肝病患者血清中的阳性率。方法 将患者分为 3组 :①自身免疫性肝病组 ,包括自身免疫性肝炎 (AIH)、原发性胆汁性肝硬化 (PBC) ,原发性硬化性胆管炎 (PSC)。②各类病毒性肝炎组 ;③不明原因肝损伤组。分别用间接免疫荧光法、免疫印迹法检测肝抗原 (SAL/LP、LKM 1、LC 1、AMA M2 )自身抗体。结果 抗SLP/LP抗体在AIH患者血清中阳性率为 4 6 .4 % ,明显高于LKM 1(13.3% )、LC 1(0 .0 % )及AMA M2 (13.3% )抗体 ,并且在病毒性肝炎患者血清中呈阴性反应。抗AMA M2抗体在PBC患者血清中阳性率达 95 .0 %。不明原因肝损伤组患者中有 10 .0 %的AMA M2抗体阳性。结论 抗SLA/LP抗体对AIH具有特异性 。

Objective To study the significance of anti-antibody of liver antigens in the diagnosis of autoimmune hepatitis disease. Methods Patients were divided into three groups according the diseases: ① Autoimmune hepatic disease including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerotic cholangitis (PSC); ② Various virus hepatitis; ③ Liver damage of unknown cause. Auto-antibody of liver antigens SLA/LP, LKM-1, LC-1, and AMA-M2 were identified by indirect immunofluorescence (IIF) assay and Immunoblot assay. Results The positive rates of anti-SLA/LP (46.6%) was significantly higher than those of anti-LKM-1 (13.3%), anti-LC-1 (0.0%), and anti-AMA-M2 (13.3%) in patients with AIH while these four antibodies were negative in patients with virus hepatitis. The positive rates of anti-AMA-M2 in patients of PBC and unknown liver damage were 95.0% and 10.0%, respectively. Conclusion Anti-SLA/LP is a new specific serum marker in diagnosis of AIH. The auto-antibody detection of liver antigens will helpful in the diagnosis and the- rapy of autoimmune hepatic disease.