原发性胆汁性胆管炎患者血清自身抗体及生化指标的特征分析

Characteristic Analysis of Sera of Autoantibodies and Biochemical Indexes of Patients with Primary Biliary Cholangitis

目的：探讨原发性胆汁性胆管炎（PBC）患者血清自身抗体及生化指标的特征及临床意义。方法采用间接免疫荧光法检测64例PBC，81例病毒性肝病，50例健康体检者三组血清中的抗核抗体（ANA）、抗线粒体抗体（AMA）；采用免疫印迹法检测三组的自身免疫肝病抗体（AMA-M2，M2-3E，抗 Sp100抗体，抗 PML抗体，抗 gp210抗体，抗 LKM-1抗体，抗 LC-1抗体，抗 SLA／LP 抗体，Ro52）；采用全自动生化分析仪检测其生化指标。结果 PBC组 ANA和 AMA阳性率明显高于病毒性肝病组，差异有统计学意义（χ2＝56.07，54.72，均P＜0.01）；PBC组自身免疫肝病抗体（AMA-M2，M2-3E，抗 Sp100抗体，抗gp210抗体，Ro52）阳性率与病毒性肝病组比较，差异有统计学意义（χ2＝9.06～98.70，均P＜0.01）；PBC组生化指标丙氨酸氨基转移酶（ALT）与病毒性肝病组比较，差异无统计学意义（F＝6.069，P＞0.05），其余总胆红素（TBIL）、天冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）和谷氨酰转肽酶（GGT）、总胆固醇（TC）与病毒性肝病组及健康对照组比较差异均有统计学意义（F＝6.069～35.56，均P＜0.05）；AMA-M2阳性和阴性的 PBC患者之间的生化指标比较差异无统计学意义（F＝0.425～2.775，P＞0.05）；抗gp210抗体阳性患者的TC高于阴性患者，差异有统计学意义（F＝4.521，P＝0.044）。结论自身抗体 ANA，AMA，AMA-M2，M2-3E，抗 Sp100抗体，抗 gp210抗体有助于 PBC的早期诊断，结合生化指标则有利于 PBC和病毒性肝病的鉴别诊断和疗效观察。此外，抗 gp210抗体阳性与 PBC患者的 TC有一定的相关性。

Objective To investigate the primary biliary cholangitis （PBC）characteristics of patients with serum autoantibod-ies and biochemical indexes and clinical significance.Methods With indirect immunofluorescence method,the serum antinu-clear antibody （ANA）and anti mitochondrial antibody（AMA）in 64 cases of PBC,81 cases of virus of liver disease and 50 cases of healthy persons were measured.Used immunoblot assay to detect autoimmune liver disease antibody （AMA-M2, M2-3E and Sp100 antibody and anti PML antibody and anti-gp210 antibody and anti LKM-1 antibody,antibody LC-1,anti SLA/LP antibody,Ro52 of three groups,and used automatic biochemical analyzer to detect the biochemical indicators.Re-sults The positive rate of ANA and AMA in PBC group was significantly higher than that of viral liver disease group,the difference was statistically significant （χ2=56.07,54.72,P〈0.01）.PBC group of autoimmune liver diseases （AMA-M2, M2-3E,anti Sp100 antibody,anti gp210 antibody,Ro52）compared with the positive rate of viral liver disease group,was sta-tistically significant the difference （χ2=9.06~98.70,P〈0.01）.Group PBC biochemical indexes of alanine aminotrans-ferase （ALT）compared with viral hepatitis group,the difference was not statistically significant （F=6.069,P〉0.05）,the total bilirubin （TBIL）and aspartate aminotransferase （AST）,alkaline phosphatase （ALP）and glutamyl transpeptidase （GGT）,total cholesterol （TC）and the difference between viral hepatitis and healthy control group were statistically signifi-cant （F=6.069~35.56,P〈0.05）;between AMA-M2 positive and negative patients with PBC students,there was no sta-tistical significance （F=0.425~2.775,P〉0.05）.The difference was statistically significant （F=4.521,P=0.044）in TC positive patients with anti gp210 antibody.Conclusion The autoantibodies included ANA,AMA,AMA-M2,M2-3E,Sp100, gp210 antibody are helpful for the early diagnosis of PBC,and differentiate the diagnosis and treatment between PBC and vi-ral hepatitis.Gp210 antibody positive is correlated with TC in PBC patients.