自身免疫性肝病及其自身抗体谱分析

Autoimmune liver diseases and their autoantibodies spectral analysis

目的探讨重庆地区不同类型自身免疫性肝病患者血清中自身抗体谱的特征及其临床应用价值。方法 743例肝病送检样本中81例确诊为自身免疫性肝病,将其分为3组:(1)自身免疫性肝炎(AIH)38例;(2)原发性胆汁性肝硬化(PBC)30例;(3)重叠综合征13例。用间接免疫荧光法检测抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(SMA)、抗肝肾微粒抗体(LKM)、抗可溶性肝抗原(SLA)等,用酶联免疫吸附试验(ELISA)定量测定抗线粒体M2亚型。结果 743例中诊断为AIH、PBC和重叠综合征分别为送检标本的5.11%、4.04%和1.75%,总计10.9%。AIH患者ANA阳性率为78.9%,AMA及M2亚型阳性率为18.4%,SMA阳性率为7.89%;PBC患者ANA阳性率为73.3%;AMA和M2阳性率为26.7%;重叠综合征患者ANA及AMA阳性率为100%。结论自身免疫性肝病抗体谱检测有助于自身免疫性肝病诊断,非病毒性肝炎诊断时应考虑自身免疫性肝病。

Objective To study the characteristics of autoantibodies spectrum of various autoimmune liver diseases in Chongqing area and its application value in clinic.Methods 81 cases diagnosed autoimmune liver diseases,from 743 tested samples of liver diseases,were collected and divided into 3 groups：autoimmune hepatitis group（AIH,38 cases）,primary biliary cirrhosis group（PBC,30 cases） and overlap syndromes group（13 cases）.First,ANA,AMA,SMA,LKM,SLA were tested by indirect immunofluorescence.Then,AMA and M2 were tested by ELISA.Results Among 743 cases,those diagnosed as AIH,PBC and overlap syndromes accounted for 5.11%,4.04% and 1.75% of the tested specimens respectively.In AIH patients,the positive rate was 78.9% in ANA,18.4% in AMA and M2 and 7.89% in ASMA;in PBC patients,the positive rate was 73.3% in ANA,26.7% in AMA and M2;in the patients with overlap syndromes,the positive rate was 100% in ANA and AMAConclusion The detection of antibodies spectrum of autoimmune 1iver diseases is helpful for diagnosis of autoimmune liver diseases and overlap syndromes;when diagnosing non viral hepatitis,autoimmune 1iver diseases should be considered.