抗核抗体定量与体液免疫指标及肝功能异常关系分析

Correlation analysis between ANA quantitation with abnormalities of humoral immune indexes and liver function

目的探讨抗核抗体(ANA)水平与体液免疫指标的关系及其与肝功能异常检出率的临床意义。方法将2011年1月至2012年1月在该院住院接受ANA检查的患者160例,根据ANA测定结果分为阴性组(n=75)和阳性组(n=85),阳性组患者再根据ANA不同水平分为3个亚组,对其进行体液免疫和肝功能检测。分别比较各组免疫球蛋白和补体水平以及肝功能异常的情况。结果 ANA阳性组免疫球蛋白IgG和IgA水平明显高于ANA阴性组,而补体C3、C4水平低于ANA阴性组,差异有统计学意义(P<0.01);ANA阳性组免疫球蛋白IgM水平与ANA阴性组比较,差异无统计学意义(P>0.05);ANA阳性各亚组间免疫球蛋白和补体水平比较,随着ANA水平的增加,其血清免疫球蛋白水平逐渐升高,而补体水平明显下降,3组间进行方差分析,差异有统计学意义(P<0.05)。ANA阳性患者中检出肝功能异常者47例,占55.23%(47/85),其中,肝酶异常22例,占46.81%(22/47),总蛋白降低有26例,A/G倒置有22例,总蛋白、清蛋白/球蛋白比值(A/G)异常共38例,占78.72%(38/47)。结论 ANA水平与体液免疫变化有密切关系,ANA阳性患者肝功能损害与患者血清中存在多种自身抗体有密切关系,ANA高水平的患者,肝功能异常检出率较高,临床医生应予以重视。

Objective To study the relationship of the ANA level with the humoral immune indexes and the abnormality detection rate of liver function and to investigate its clinical significance.Methods 160 inpatients with ANA determination in this hospital from January 2011 to January 2012 were divided into the negative group（75 cases） and positive group（85 cases） according to the ANA detection results.The positive group was redivided into 3 subgroups according to different ANA levels and performed the humoral immune and liver function detection.The immunoglobulin,complement levels and abnormal liver function were compared among various groups.Results The levels of immunoglobulin IgG and IgA in ANA positive group were significantly higher than those in the ANA negative group,while the complement C3 and C4 levels were lower than those in the ANA negative group,the difference showing statistical significance（P0.01）.Comparison of the immunoglobulin and complement levels among various subgroups,the immunoglobulin level was gradually increased with the ANA level increase,while the complement level was decreased,the variance analysis showed that the statistical difference existed among 3 groups（P0.05）.47 cases with abnormal liver function were detected in ANA-positive patients,accounting for 55.23%（47/85）,including 22 cases（46.81%,22/47） of abnormal liver enzymes,26 cases of total protein decreasing,22 cases of A/G inversion,38 cases（78.72%,38/47） of abnormal total protein and A/G.Conclusion The ANA level is closely correlated with alteration of humoral immune.Impaired liver function in ANA-positive patients is closely related to the existence of a variety of autoantibodies in serum.The positive rates of abnormal liver function is high in the patients with high level of ANA.Clinicians should take it seriously.