联合检测血清ANA、SMA、PANCA、LKM、SLA在自身免疫性肝炎中的应用

Application of combined detection of serum ANA, SMA, PANCA, LKM and SLA in autoimmune hepatitis

目的评价血清抗核抗体(ANA)、抗平滑肌抗体(SMA)、抗髓过氧化物酶抗体(PANCA)、肝肾微粒体抗体(LKM)、抗可溶性肝抗原抗体(SLA)联合检测自身免疫性肝炎的应用价值。方法选择2015年8月~2017年8月期间赣州市第五人民医院收治的40例自身免疫性肝炎患者与40例其他肝病患者,将前者设为观察组,后者设为对照组,两组患者分别实施血清ANA、SMA、PANCA、LKM、SLA联合检测与常规生化检验,分析两组检验结果。结果两组TBIL、DBIL、γ-GT、白/球比、AST、ALT、IgM、IgG、IgA水平相比,差异无统计学意义(P>0.05);观察组ANA、SMA阳性检出率明显高于对照组,差异有统计学意义(P<0.05),而观察组PANCA、LKM、SLA阳性检出率与对照组相比差异无统计学意义(P>0.05);观察组ANA、SMA、PANCA、LKM、SLA联合检测阳性检出率明显高于单独检测阳性检出率,差异有统计学意义(P<0.05)。结论在自身免疫性肝炎疾病诊断中,采用血清ANA、SMA、PANCA、LKM、SLA联合检测,可提高诊断效果,为临床诊治方案的制定提供有效的参考依据,值得临床推广应用。

Objective To evaluate the application value of combined detection of serum antinuclear antibody(ANA), anti-smooth muscle antibody(SMA), anti-myeloperoxidase antibody(PANCA), liver kidney microsomal antibody(LKM), and soluble liver antigen antibody(SLA) in autoimmune hepatitis. Methods 40 patients with autoimmune hepatitis and 40 patients with other liver diseases who were admitted to Ganzhou Fifth People's Hospita from August 2015 to August 2017. The former was set as the observation group, and the latter was set as the control group. The two groups of patients were given the combined detection of serum ANA, SMA, PANCA, LKM, SLA and routine biochemical tests. The two groups of test results were analyzed. Results The differences in TBIL, DBIL,γ-GT, white/ball ratio, AST, ALT, IgM, IgG and IgA levels were not statistically significant between the two groups(P>0.05);the positive detection rate of ANA and SMA in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05). The positive detection rate of PANCA, LKM and SLA in the observation group was not statistically significantly different compared with the control group(P>0.05);the positive detection rate of the combined detection of ANA, SMA, PANCA, LKM and SLA in the observation group was significantly higher than that of separate detection, and the differences were statistically significant (P<0.05). Conclusion In the diagnosis of autoimmune hepatitis, combined detection of serum ANA, SMA, PANCA, LKM and SLA can improve the effect of diagnosis, and provide an effective reference for the development of clinical diagnosis and treatment protocols, which is worthy of clinical promotion and application.