肝功能血清学指标异常对抗核抗体检测结果的干扰分析

Interference Analysis of Abnormal Serum Markers of Liver Function Against Anti-Nuclear Antibodies Detection

目的 探讨肝功能损伤时引起的肝功能血清学指标升高对抗核抗体（anti-nuelear antibodies,ANA）检测结果是否存在干扰,从而造成ANA（1∶40）低滴度结果出现,为临床提供参考.方法 回顾性收集157例间接免疫荧光法检测ANA为1∶40低滴度的病例,按新华医院分诊制度分12岁以上成人组125例,12岁及12岁以下儿童组32例,分析其肝功能血清学指标：主要以丙氨酸氨基转移酶 （ALT）,天冬氨酸氨基转移酶（AST）,碱性磷酸酶（ALP）,γ-谷氨酰转肽酶（GGT）为主,同时分别收集成人66例,儿童42例ANA阴性的样本作为对照.结果 成人组125例ANA结果为1∶40低滴度的样本中,ALT阳性率为28.0%;AST阳性率35.2%;ALP阳性率26.4%;GGT阳性率33.6%,与ANA阴性对照组统计,P均〈0.05,说明差异有统计学意义;儿童组32例,ALT阳性率为31.3%;AST阳性率43.8%;ALP阳性率90.6%;GGT阳性率25.0%,与ANA阴性对照组统计,除ALP组外,其它三组均P〈0.05,说明差异有统计学意义.结论 肝功能损伤时引起的肝功能血清学指标异常升高,均对ANA检测结果存在干扰,会产生低滴度的结果.儿童因正常生长发育而引起的ALP升高,对ANA检测结果无干扰.

Objective To investigate the interference of elevated serum markers of liver function caused by liver injury against the test results of anti-nuclear antibodies（ANA）,analyse the reasons of low-liter of ANA（1 ： 40） and provide referenees for clinical diagnosis. Methods This retrospective study was performedon 157 patients with low-liter ANA （1 ： 40）. xinhuay hospital triage system,the patients were divided into 125 adult patients （more than 12 years old） and 32 pediatric patients （not more than 12 years of age）. Control group was formed by 66 adults and 42 children. The serum markers of liver function were analysed,including ALT,AST,ALP,GGT and so on. Results In adult patient group,the significant changed levels of serum markers of liver function were found compared with the control group （P〈0. 05）,with ALT-positire rate of 28. 0% ,AST-positive rate of 35.2% ,ALP-positive rate of 26.4% and GGT-positive rate of 33.6%. The pediatric patients showed significantly evaluated levels of serum markers of liver function in addition to ALP levels （P〈0.05）, with ALT-positive rate of 31-3%,AST-positive rate of 43.8%,GGT-positive rate of 25.0%, and ALP-positive rate of 90. 6%. Conclusion The interference of elevated serum markers of liver function caused by liver injury on the test results of low-titer ANA were found. However,the rise of ALP levels based on the normal growth and development in children results on non-interference against ANA detection.