抗髓过氧化物酶及乳铁蛋白抗体对自身免疫性肝炎检测的临床研究

Survey on the detection of anti-myeloperoxidase antibody and anti-lactoferrin antibody in patients with autoimmune hepatitis

目的:探讨抗髓过氧化物酶抗体(AMPA)及抗乳铁蛋白抗体(ALA)对自身免疫性肝炎(AIH)检测的临床意义及评估。方法:对63例AIH(53例AIH-Ⅰ和10例AIH-Ⅱ)、206例非AIH患者和50例健康体检者均采用ELISA法检测AM-PA和ALA;间接免疫荧光法(IIF)检测抗核抗体(ANA)、抗平滑肌抗体(ASMA)和抗中性粒细胞胞质抗体(ANCA),观察临床评价指标,并对结果进行回顾性分析。结果:63例AIH和206例非AIH检测AMPA阳性率分别是61.9%(39/63)和3.40%(7/206),经χ2检验,P<0.01;AIH组中AIH-Ⅰ组阳性率73.6%(39/53)。63例AIH患者检测ALA阳性12例(19.0%),AIH-Ⅰ中阳性11例(20.8%)。AIH自身抗体临床评价指标显示ALA敏感性最低为19.05%,但其特异性最高为99.6%,AM-PA特异性为97.27%。结论:AMPA、ALA与AIH的发生发展存在相关性,两者联合其他自身抗体检测对AIH的诊断及其亚型的鉴别有重要意义。

Objective：To explore the significance and clinical value of anti-myeloperoxidase antibody（AMPA） and anti-lactoferrin antibody（ALA） detection in diagnosis of autoimmune hepatitis（AIH）.Methods： A total of 63 AIH patients,including 53 AIH-Ⅰ and 10 AIH-Ⅱ,206 non-AIH patients and 50 healthy volunteers were included in this subject.Enzyme-linked immunosorbent assay（ELISA） was utilized to detect AMPA and ALA while indirect immunofluorescence（IIF） was employed to detect anti-nuclear antibodies（ANA）,anti-smooth muscle antibodies（ASMA） and anti-neutrophil cytoplasmic antibodies（ANCA）.Investigate the clinical characteristics and analyze the results respectively.Results： The positive rates of AMPA were 61.9%（39/63） in AIH group compared with 3.40%（7/206） in non-AIH group（P〈0.01） and 73.6%（39/53） in AIH-Ⅰ group.The positive rates of ALA were 19.0%（12/63） in AIH group and 20.8%（11/53） in AIH-Ⅰ group.The clinical indexes of AIH associated autoantibodies indicated that the ALA had the lowest sensitivity（19.05%）,but with the highest specificity（99.6%）.The specificity of AMPA was 97.27%.Conclusion： AMPA and ALA may play a role in the development of AIH,the combined detection of AMPA and ALA would be helpful in the diagnosis of AIH and AIH subtypes.