抗线粒体抗体阳性和阴性PBC患者临床表现、血清学和免疫学指标及病理特征比较

Comparison of clinical manifestations,serological and immunological parameters and pathological features of PBC patients with positive or negative anti-mitochondrial antibody

目的:探讨抗线粒体抗体(AMA)阳性和阴性的原发性胆汁性肝硬化(PBC)患者的临床表现、血清学和免疫学指标及病理特征。方法:选取98例PBC患者,采用间接免疫荧光法测定AMA和AMA-M2,两者均为阳性者即为AMA阳性组,均阴性者为AMA阴性组。观察比较2组患者的临床表现、血清学和免疫学指标、病理特征。结果:98例PBC患者中,AMA阳性组有81例(82.7%),AMA阴性组有17例(17.3%)。2组患者的临床表现、血清学指标、病理特征和分期间的差异均无统计学意义(均P>0.05)。AMA阳性组患者IgM水平均明显高于AMA阴性组,AMA阳性组患者ANA、SMA阳性率均明显低于AMA阴性组,差异有统计学意义(P<0.05)。结论:AMA阳性与阴性PBC患者的临床表现、血清学指标、病理特征和分期相似,但AMA阳性PBC患者的血清IgM水平升高,ANA、SMA阳性率降低。

Objective：To investigate the clinical manifestations,serological and immunological parameters and pathological features of primary biliary cirrhosis（PBC）patients with positive or negative anti-mitochondrial antibody.Method：A total of 98 patients with PBC were chosen,whose AMA and AMA-M2 were detected by indirect immunofluorescence assay.Both of them were positive for AMA positive group and negative for AMA negative group.The clinical manifestations,serological and immunological parameters and pathological features of the two groups were observed and compared.Result：Of all the 98 PBC patients,81（82.7%）were AMA-positive and 17（17.3%）were AMA-negative.There were no significant differences in the clinical manifestations,serological parameters,pathologic features and stages between the two groups（P0.05）.IgM levels in patients with AMApositive group were significantly higher than those in AMA-negative group.The positive rates of ANA and SMA in AMA-positive group were significantly lower than those in AMA-negative group（P0.05）.Conclusion：The clinical manifestations,serological indicators,pathological features and staging are similar between the AMA-positive group and AMA-negative group,but the IgM level is increased and the positive rate of ANA and SMA are decreased in AMA-positive patients with PBC.