原发性胆汁性肝硬化患者抗线粒体抗体亚型、肝功能及其免疫学指标检测意义

Changes in serum levels of anti-mitochondrial antibody subtypes,liver function indexes,and immunological indexes in patients with primary biliary cirrhosis

目的探讨原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者抗线粒体抗体(antimitochondrial antibody,AMA)亚型的检测意义及其肝功能、免疫学指标变化分析.方法选择2014-01/2016-08在浙江中医药大学附属第三医院门诊或住院的72例PBC患者作为研究对象;同时选取88例非PBC患者和50例健康正常者进行对照.观察3组间血清AMA及其亚型的表达水平、肝功能变化及免疫学指标变化情况.结果斑点法检测PBC组抗M2抗体、抗M4抗体、抗M9抗体阳性率分别为63.8%、38.9%、22.2%,抗M2和M4抗体同时阳性为30.6%,抗M2和M9抗体同时阳性为25.0%,抗M2、M4和M9抗体同时阳性为16.7%,检出率均明显高于正常组和非PBC组,差异有统计学意义(P<0.05);与正常组比较,非PBC组和PBC组患者肝功能指标变化均不同程度增高,且PBC组明显高于非PBC组,差异有统计学意义(P<0.05);与正常组比较,非PBC组和PBC组患者免疫学指标均不同程度增高,且PBC组比非PBC组明显增高,差异有统计学意义(P<0.05).而补体C3、C4在3组间均无明显差异(P>0.05).结论 AMA抗体的检测对诊断PBC有重要价值,其肝功能和免疫学指标的变化对PBC患者的病情评估有重要意义.

AIM To detect the changes in anti-mitochondrial antibody（AMA） subtypes,liver function,and immunological indexes in patients with primary biliary cirrhosis（PBC） and to analyze their clinical significance.METHODS Seventy-two PBC patients treated between January 2014 and August 2016 at our hospital,88 non-PBC patients and 50 normal healthy controls were included in this study.Serum levels of AMA subtypes,liver function indexes,and immunological indexes were compared between the three groups.RESULTS Of all PBC patients,63.8% were positive for AMA-M2,38.9% positive for AMA-M4,22.2% positive for AMA-M9,30.6% positive for both AMA-M2 and AMA-M4,25.0% positive for both AMA-M2 and AMA-M9,and 16.7%positive for all three subtypes.The positive rates of AMA subtypes were significantly higher in PBC patients than in the other two groups（P〈0.05）.Compared with the normal control group,liver function indexes increased to different extents in the PBC and non-PBC groups,and the increase was more significant in the PBC group than in the non-PBC group（P〈0.05）.Compared with the normal control group,immunological indexes increased to varying degrees in the other two groups,and the increase was more significant in the PBC group（P〈0.05）.C3 and C4 had no obvious differences between the three groups（P〉0.05）.CONCLUSION AMA detection has important value in the diagnosis of PBC,and the changes in liver function and immunological indexes are of great significance for evaluation of the condition of patients with PBC.