原发性胆汁性肝硬化免疫学指标检测的临床意义

Autoimmune related clinical tests in diagnosis of primary biliary cirrhosis

为研究原发性胆汁性肝硬化(PBC)免疫学指标测定的临床意义,选取32例确诊PBC的住院患者,采用ELISA法检测患者血清中的抗线粒体抗体M2亚型(AMA-M2);间接免疫荧光法检测抗线粒体抗体(AMA),抗核抗体(ANA),抗平滑肌抗体(SMA);斑点法检测抗肝肾微粒体抗体(LKM-1),抗肝溶质Ⅰ型抗原抗体(LC-1),抗可溶性肝抗原/肝胰抗原抗体(SLA/LP);免疫比浊法检测免疫球蛋白(IgG,IgA,IgM)和类风湿因子(RF)。同时观察AMA-M2与生化肝功指标的关系,比较PBC患者治疗前后AMA-M2的变化。结果显示诊断PBC意义最大的是AMA-M2,其阳性率最高达94%,其次是AMA和ANA,阳性率分别为88%和86%;AMA-M2值的高低与血清转氨酶、碱性磷酸酶和γ-谷氨酰转肽酶无关,熊去氧胆酸治疗前后AMA-M2变化不大。

Thirty -two patients diagnosed of primary biliary cirrhosis （PBC） were detected antimitochondrial antibody M2 subtype （ AMA - M2） by ELISA, antimitocbondrial antibody （AMA） and anti - nuclear antibody （ANA） by indirect immune -fluorescence assay, other autoimmune antibody were also detected. It was shown that serum AMA - M2 antibody had the highest sensitivity and specificity of 94% for PBC, higher than AMA and ANA. The level of AMA - M2 had no close relation with the severity of the PBC itself. Furthermore, AMA - M2 did not significantly change after ursodeoxylic acid treatment.