自身免疫性肝病相关自身免疫性抗体检测的临床应用

Clinical Application of Autoimmune Antibody Detection in Autoimmune Liver Disease

目的研究自身免疫性肝病相关自身免疫性抗体检测的临床应用。方法选取2019年6月-2020年12月我院传染科接诊的140例肝病患者为研究对象,其中原发性胆汁性肝硬化(PBC)34例、自身免疫性肝炎(AIH)60例、丙肝6例、血吸虫肝病4例、肝硬化24例、肝功能不全10例、药物性肝炎2例,比较各组患者的自身抗体检出情况、PBC组和AIH组患者肝功能水平以及ANA荧光核型。结果PBC、AIH患者的CENPB、M2、GP210、SP100、LKM-1检出率均高于丙肝、血吸虫病、肝硬化、肝功能不全、药物性肝炎,M2抗体检出阳性率高于而CENPB、GP210、SP100、LKM-1检出率,差异有统计学意义(P<0.05);AIH患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)水平高于PBC患者,差异有统计学意义(P<0.05);AIH患者ANA荧光核型中均质型比例高于PBC患者,颗粒型低于PBC患者,差异有统计学意义(P<0.05),二者核仁型、胞浆颗粒型比较,差异无统计学意义(P>0.05)。结论自身免疫性肝病患者自身免疫性抗体检测具有重要临床价值,可作为临床判断疾病类型的重要指标。同时可进一步联合肝功能指标检测、ANA荧光核型进一步鉴别诊断。

Objective To study the clinical application of autoimmune antibody detection related to autoimmune liver disease.Methods A total of 140 patients with liver diseases admitted to our hospital from June 2019 to December 2020 were selected as the study subjects,including 34 cases of primary biliary cirrhosis(PBC),60 cases of autoimmune hepatitis(AIH),6 cases of hepatitis C,4 cases of schistosomiasis liver disease,24 cases of liver cirrhosis,10 cases of liver dysfunction,and 2 cases of drug-induced hepatitis.The detection of autoantibodies,liver function levels and ANA fluorescence karyotype in PBC group and AIH group were compared.Results The detection rates of CENPB,M2,GP210,SP100 and LKM-1 in PBC and AIH patients were higher than those in hepatitis C,schistosomiasis,cirrhosis,liver dysfunction and drug-induced hepatitis,the detection rates of M2 were higher than CENPB,M2,GP210,SP100 and LKM-1,and the difference was statistically significant(P<0.05).Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamine transpeptidase(GGT)and alkaline phosphatase(ALP)levels in AIH patients were higher than those in PBC patients,and the difference was statistically significant(P<0.05).The proportion of ANA fluorescence karyotype of AIH patients was higher than that of PBC patients,and the proportion of granular type was lower than that of PBC patients,the difference was statistically significant(P<0.05);there was no significant difference in nucleolar type and cytoplasmic granule type between the two groups(P>0.05).Conclusion The detection of autoimmune antibodies in patients with autoimmune liver disease has important clinical value,which can be used as an important indicator for clinical judgment of disease types.At the same time,it can be further combined with liver function index detection and ANA fluorescence karyotype for further differential diagnosis.