老年原发性胆汁性肝硬化患者抗核抗体特征分析

Profiles of antinuclear antibodies in senile primary biliary cirrhosis patients

目的分析抗核抗体在老年原发性胆汁性肝硬化（PBC）患者的表现特征。方法应用间接免疫荧光检测70例老年PBC患者及360例对照者的血清抗核抗体（ANA），并应用免疫印迹法检测其抗线粒体抗体M2亚型（AMA-M2）、抗核点型SP100抗体、抗核膜型gp210抗体。结果70例老年PBC患者中有66例ANA阳性（94％），其中43例表现为混合荧光模式。AMA-M2检出率为90％。ANA主要荧光模式对老年PBC患者敏感性88％（62／70），特异性为91．6％（330／360），83．3％ANA滴度≥1：1000，与对照组比较差异有统计学意义（P〈0．01）。结论老年PBC患者ANA的荧光模型主要为核膜型、核点型、着丝点型、胞浆颗粒型，常表现为混合荧光模型，对于老年PBC具有重要的诊断价值。

Objective To analyze the profiles ofantinuclear antibody（ANA） in senile primary biliary cirrhosis（PBC） patients. Methods Indirect immunofluorescence was used to test ANA in the serum samples of 70 senile PBC patients and of 360 aged-matched controls, including 120 health individuals, 80 patients with viral hepatitis, 40 with reumatoid arthritis, 30 with autoimmune hepatitis, 30 with mixed connective tissue disease, 30 with systemic lupus erythematosus, and 30 with systemic sclerosis. Immunoblot analysis was applied to examine AMA-M2, antinuclear dots pattern SP100 antibody and antinuclear membrane pattern gp210 antibody. Results In the 70 senile PBC patients, there were 66 positive with ANA （94%）, with 43 cases of mixed immunofluorescence patterns. The positivity rate of AMA-M2 was 90%. For major immunofluorescence patterns of ANA in the senile PBC, the sensitivity was 88% （62/70）, and the specificity was 91.6% （330/360）. More over, 83.3% of senile PBC patients had ANA titer ≥1 ： 1000, which was significantly different from the controls （P 〈 0.01） Conclusion Immunofluorescence patterns of ANA in senile PBC patients are nuclear membrane pattern, nuclear dots pattern, centromere pattern and cytoplasm speckled pattern, and they usually present as mixed immunofluorescence pattern. ANA is of great value in the diagnosis of senile PBC.