抗着丝点抗体阳性原发性胆汁性肝硬化患者血清学及影像学特征分析

Serological and imaging study of positive anti-centromere antibody in patients with primary biliary cirrhosis

目的探讨抗着丝点抗体(ACA)检测对原发性胆汁性肝硬化(PBC)患者的诊断价值以及ACA阳性PBC患者的血清学及影像学特征。方法收集本院就诊的163例PBC患者,间接免疫荧光法检测抗核抗体(ANA)、抗着丝点抗体(ACA),免疫印迹法检测抗线粒体抗体M2抗体(AMA-M2)、抗ENA抗体并检测其生化和免疫指标,应用瞬时弹性成像技术(Fibro Touch)检测肝脏硬度(LSM),比较ACA阳性和阴性患者的血清学指标以及Fibro Touch定量分析结果的区别。结果 163例PBC患者中AMA-M2阳性143例(87.7%),ACA阳性92例(56.4%),20例AMA-M2阴性PBC患者中ACA阳性为16例(80.0%);单纯ACA阳性(ANA阴性)有50例(30.7%),ACA和ANA均为阴性的有43例(26.4%),这2组间指标TBIL、IgG以及LSM差异均有统计学意义(P<0.05)。结论 ACA是M2阴性PBC患者的一个重要标志;单纯ACA阳性的PBC患者肝纤维化进程较为缓慢。

Objective To explore the diagnostic value of detecting anti-centromere antibody（ACA）in patients with primary biliary cirrhosis（PBC）and the serological and imaging features of PBC patients with positive ACA.Methods Clinical data of163 PBC patients were collected to detect ANA,ACA,AMA-M2,anti-ENA antibody,biochemical indicator and immune index by indirect immunofluorescence.Transient elastography technology（Fibro Touch）was utilized to detect liver stiffness（LSM）,so as to compare serologic indicators of ACA positive patients with those of ACA negative patients,and the differences of Fibro Touch quantitative analysis results should also be compared.Results Of 163 PBC patients,143 cases were AMA-M2 positive（87.7%）,92 cases were ACA positive（56.4%）.Of the 20 PBC patients of AMA-M2 negative,16 cases were ACA positive（80.0%）.50 cases（30.7%）were ACA positive（ANA negative）and 43 cases were ACA and ANA negative（26.4%）.There was statistical significance on the differences between the two groups in TBIL,Ig G and LSM（P 0.05）.Conclusion ACA is a significant indicator in PBC patients of M2 negative.For PBC patients of ACA positive,their liver fibrosis progresses more slowly.