225例肝病患者自身抗体检测结果分析

Autoantibody test results analysis of 225 patients with liver disease

目的探讨各种肝病患者中自身抗体检测在自身免疫性肝病(autoimmune liver disease,ALD)包括自身免疫性肝炎(autoimmune hepatitis,AIH)、原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)及原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)中的临床意义。方法选择我院2013年1月-2014年2月消化科、肝胆外科、移植外科等收治的各种肝病患者225例,分为ALD患者组和其他肝病患者组。用间接免疫荧光法检测225份临床血清标本中抗核抗体(antinuclear antibody,ANA)、抗平滑肌抗体(antismooth muscle antibody,SMA)和抗线粒体抗体(anti—mitochondrial antibody,AMA),用欧蒙印迹法检测抗肝肾微粒体抗体(liver kidney microsomal,LKM)、抗肝细胞溶质抗原Ⅰ型抗体(liver cytosol—1,LC—1)、抗可溶性肝抗原抗体/抗肝胰抗体(anti—soluble liver antigen antibody/liver pancreas antigen,SLA/LP)、AMAⅡ型(AMA—M_2)并查阅临床资料,对检测结果作出分析。结果 ALD患者组ANA阳性率为77.78%,SMA阳性率为7.41%,AMA阳性率为55.56%,LKM阳性率为7.41%,AMA—M_2阳性率为48.15%,SLA/LP阳性率为7.41%,LC—1阳性率为3.70%。其他肝病患者组ANA阳性率为26.26%,SMA阳性率为4.55%,AMA阳性率为11.11%,LKM阳性率为0.51%,AMA—M_2阳性率为5.05%,SLA/LP阳性率为2.53%,LC-1阳性率为1.52%。ALD患者组自身抗体阳性率与其他肝病患者组相比较,ANA、AMA、LKM、AMA—M_2差异均有统计学意义(P均<0.05)。结论 ALD患者自身抗体检出率较高,为临床医生鉴别病毒性肝炎、ALD及其他肝病提供可靠依据。

Objective To investigate the clinical value of autoantibodies detection in autoimmune liv-er disease（ALD） including autoimmune hepatitis（AIH）, primary biliary cirrhosis（PBC） and primary scleros-ing cholangitis （PSC）. Methods From January 2013 to February 2014, 225 patients from department of gas-troenterology, department of hepatobiliary surgery and transplant surgery were collected. Antinuclear antibody （ANA）, antismooth muscle antibody（SMA） and anti-mitochondrial antibody（AMA） were detected by indirect immunofluorescence method. Liver kidney microsomal antibody（LKM）, liver cytosol-1（LC-1）, soluble anti-gen/liver pancreatic（SLA/LP） and AMA-M2 were tested by Europe and Mongolia blotting detection. The clin-ical datas were consulted and the detected results were analyzed statistically. Results The positive rates of ANA, SMA, AMA, LKM, AMA-M2, SLA/LP and LC-1 in patients with ALD were 77.78%, 7.41%, 55.56%, 7.41%, 48.15%, 7.41%and 3.70%, respectively. The positive rates of ANA, SMA, AMA, LKM, AMA-M2, SLA/LP and LC-1 in patients with other liver diseases were 26.26%, 4.55%, 11.11%, 0.51%, 5.05%, 2.53%and 1.52%, respectively. There were statistical significance in the differences of positive rates of ANA, AMA, LKM, AMA-M2 between ALD and other liver diseases group （Pall〈0.05）. Conclusion Au-toantibodies of ALD have a higher detection rate , and they provide a reliable basis for clinicians to identify vi-ral hepatitis, ALD and other liver diseases.