联合血清ASMA、ANA检测于慢性丙型肝炎与自身免疫性肝炎鉴别诊断中的应用价值分析

Application Value Analysis of Differential Diagnosis of Chronic Hepatitis C and Autoimmune Hepatitis by Combined Serum ASMA and ANA

目的探讨患者自身血清中抗体的特征、相关性于自身免疫性肝炎(AIH)及丙型肝炎(HCV)中的鉴别诊断价值。方法整群选取2014年2月—2015年3月于该院住院治疗的AIH患者48例及丙型肝炎患者40例,检测其ANA、ASMA等相关自身抗体,分析其与AIH、HCV间关系。结果与HCV患者血清ANA、ASMA阳性率(7.5%,20.0%)对比,AIH患者两项指标均较高(89.6%,75.0%),差异有统计学意义(P<0.01);AIH患者血清ANA多为高滴度(≥1:160),HCV患者多为低滴度(≤1:80);两组患者ANA均质型差异无统计学意义(P>0.05);AIH组患者血清ASMA肌动蛋白检出率明显高于HCV组,差异有统计学意义(P<0.01);两组患者ASMA-AA、ANA-H联合检测对比,差异有统计学意义(P<0.01)。结论对AIH及HCV患者进行ANA、ASMA联合检测,于两种疾病的治疗及鉴别诊断中意义重大。

Objective To discuss the differential diagnostic value of antibody in the serum of the patient＇s own characteris-tics, the correlation in autoimmune hepatitis （AIH） and hepatitis c （HCV）. Methods 40 patients with AIH and 48 patients with hepatitis C treated from February 2014 to March2015 in the hospital were selected, and their ANA, ASMA and other related autoantibodies were detected, and their relationship with AIH and HCV was analyzed. Results The positive rate of serum ANA and ASMA in AIH patients（89.6%,75.0%）were higher than those in HCV patients （7.5%,20.0%）and the dif-ference was statistically significant （P〈0.01）; serum ANA in AIH patients were mostly high titer （≥1：160）and serum ANA in HCV patients were mostly low titer （≤1：80）, ANA homogeneous type difference between two groups of patients had no statistically significance （P〉0.05）;The detection rate of ASMA in serum of AIH group was significantly higher than that in HCV group, and the difference was statistically significant （P〈0.01）; Combined detection of ASMA - AA and ANA - H of two groups of patients was compared, the difference was statistically significant （P〈0.01）. Conclusion Combined detection of ASMA and ANA in patients with AIH and HCV has an significant impact on the diagnosis and differential diagnosis of the two diseases.