肝肾阴虚与肝郁脾虚型原发性胆汁性肝硬化生化及免疫学指标比较

Biochemical and Immunological Indexes Comparison in Primary Biliary Cirrhosis Belonged to the Type of Hepatic and Renal Yin Deficiency and Liver Depression and Apleen Deficiency

目的比较肝肾阴虚型与肝郁脾虚型原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者生化及免疫球蛋白,探寻PBC的中医病机演变规律。方法选取解放军第三零二医院2006～2010年确诊PBC患者81例,包括肝肾阴虚型39例,脾胃气虚型42例,采用日本7080全自动生化仪检测血清ALT、AST、TBIL、DBIL、ALP、GGT、TBA、ALB、GLO、TC、TG,免疫球蛋白(IgA、IgG、IgM),血常规。采用间接免疫荧光法检测ANA、AMA;采用免疫印记法(EUROLINE)检测抗线粒体抗体M2亚型(M2)、抗早幼粒细胞白血病蛋白抗体(PML)、抗核点型靶抗原蛋白100KDa(SP100)、抗重组M2融合蛋白抗体(BPO)、抗52KD核颗粒蛋白抗体(52KD);采用酶联免疫吸附试验(ELIAS)检测抗HAVIgM、HBsAg、抗-HBs、抗-HBe、HBeAg、抗-HBe、、抗-HCV、抗-HDV、抗HEVIgM、抗EB病毒IgM和抗巨细胞病毒IgM、IgG。结果肝肾阴虚型PBC患者病情发展到失代偿期肝硬化患者比例明显高于肝郁脾虚,肝肾阴虚型PBC患者较肝郁脾虚型PBC患者TBIL、DBIL水平明显偏高、PT明显偏长、PA明显偏低、IgM明显偏高(P<0.05)。

Objective to compare biochemical parameters and Immunoglobulin in patients with PBC who are liver kidney yin deficiency type and liver strong spleen weak type, explore Primary biliary cirrhosis traditional chinese medicine Pathogenesis evolution. Methods from 2006 to 2010, select 81 Inpatients with PBC in 302 Hospital of PLA, including 39 liver kidney yin deficiency type patients and 42 liver strong spleen weak type patients,Automatic biochemical analyzer detect serum ALT、AST、TBIL、DBIL、ALP、GGT、TBA、ALB、GLO、TC、TG, immunoglobulin （IgA、IgG、IgM）, routine blood analysis.Autoantibodies were tested in each sample by immunoblotting and indirect immunofluorescence. Conclusion PBC patients progression to decompensated cirrhosis with liver-kidney yin deficiency type was significantly higher than liver strong spleen weak type, The level of TBIL and DBIL was significantly higher than liver strong spleen weak type （P0.05）; PT was significantly longer than the liver strong spleen weak type （P0.05）, PA was significantly lower than the liver strong spleen weak type （P0.05）; IgM was significantly higher than the liver strong spleen weak type （P0.05）, Difference between the two was significant statistically.