丙型肝炎患者自身抗体检测的临床意义

Clinical Significance of Auto Antibodies Detection in Patients with Hepatitis C

目的探讨丙型肝炎患者自身抗体检测的临床意义。方法收集HCV抗体及HCV—RNA阳性患者血清297例，采用间接免疫荧光法（IIF），免疫印迹法检测抗核抗体（ANA）、抗平滑肌抗体（SMA），抗肝肾微粒体I型抗体（LKM-1）和抗肝细胞浆Ⅰ型（LC-1）等肝特异性自身抗体。结果297例丙型肝炎患者中，98例患者至少一项自身抗体阳性，阳性率为32．9％，其中ANA检出率为32．9％，SMA检出率为1．3％，LKM-1检出率为3．0％，LC-1检出率为0．3％，抗体检测阳性率与作为阴性对照的HBV感染组及正常对照组间比较差异有统计学显著性意义（P〈0．01）。检测中自身抗体以中、低浓度抗体为主，主要以ANA为主。抗体滴度≥1：100的丙型肝炎患者血清中ALT，AST，Tbil，GGT及IgG含量明显高于抗体滴度〈1：100患者，但ALP，IgA，IgM含量比较差异无统计学意义。结论HCV感染过程中可引发机体自身免疫紊乱产生自身抗体，自身抗体的出现对丙型肝炎患者的肝细胞可造成一定的损伤。注重自身抗体及其浓度的检测对丙型肝炎患者的治疗有一定的拳者价值．

Objectives To investigate the clinical significance of auto antibodies detection in patients with hepatitis C. Methods Sera from 297 patients with both positive anti-HCV and HCV-RNA were collected and the specific auto-antibodies of liver such as ANA,anti-SMA,anti-LKM-1 and anti-Lc-1 were tested by IIF and WB. Results Atleast one kind of auto-antibodies existed in sera of 98（32.9%） cases in which ANA was 32.9%,anti-SMA was 1.3%,anti-LKM-1 was 3.0% ,and anti-LC-1 was 0.3% ,respectively. And there had significant differences compared with that in sera of HBV-infection group and that of control group （P〈0.01）. The titers of autoantibody were mainly middle to low. The levels of ALT,AST,Tbil,GGT and IgG in sera of patients with ANA titer ≥1 ： 100 were significantly higher than that of patients with ANA titer 〈1：100,but the levels of ALP,IgA and IgM in sera of the above patients had not difference. Conclusion Autoantibody can result from autolmmune disorder when infected with HCV and can result in liver injury to some degree. Tests of autoantibodies and there level in sera have clinical significance in the therapy of HCV infection.