血清自身抗体检测在肝功能异常患者自身免疫性肝病中的诊断价值

Diagnostic value of serum autoantibodies in patients with autoimmune liver disease with abnormal liver function

目的探究血清自身抗体检测在肝功能异常患者自身免疫性肝病(ALD)中的诊断价值。方法选取2017年6月至2020年6月本院检出的80例肝功能异常患者作为ALD组,另选取同期体检健康的80名受检者作为健康组,两组均行血清自身抗体检测与肝功能指标检测,比较两组血清自身免疫阳性率、ALD组自身免疫性肝炎(AIH)患者与原发性胆汁性胆管炎(PBC)患者血清自身免疫阳性率、两组肝功能指标及ALD组AIH患者与PBC患者肝功能指标。结果ALD组血清自身免疫阳性率为71.3%,明显高于健康组的2.5%,差异有统计学意义(P<0.05)。AIH患者的检测结果中以抗核抗体(ANA)为主,其阳性检出率为60.0%,明显高于PBC患者的20.0%,差异有统计学意义(P<0.05);PBC患者中以抗线粒体抗体M2型(AMA-M2)为主,其阳性检出率为40.0%,明显高于AIH患者的2.9%,差异有统计学意义(P<0.05)。ALD组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)水平均明显高于健康组,差异有统计学意义(P<0.05)。AIH患者ALT水平高于PBC患者,AST、GGT、ALP水平均低于PBC患者,差异均有统计学意义(P<0.05)。结论血清自身抗体检测在肝功能异常患者自身免疫性肝病的临床诊断中具有显著的应用价值,可应用于该病的早期筛查,且配合肝功能指标检测可获得更准确的诊断结果。

Objective To explore the diagnostic value of serum autoantibodies in autoimmune liver disease(ALD)in patients with abnormal liver function.Methods 80 patients with abnormal liver function detected in our hospital from June 2017 to June 2020 were selected as the ALD group,and another 80 healthy subjects during the same period were selected as the healthy group.Serum autoantibodies and liver function indicators were detected in both groups.The serum autoimmune positive rates of the two groups,the serum autoimmune positive rates of autoimmune hepatitis(AIH)patients and primary biliary cholangitis(PBC)patients in ALD group,the liver function indicators of two group and the liver function indicators of AIH patients and PBC patients in ALD group were compared.Results The positive rate of serum autoimmunity in the ALD group was 71.3%,which was significantly higher than 2.5%in the healthy group(P<0.05).Antinuclear antibody(ANA)was mainly detected in patients with AIH,and the positive detection rate was 60.0%,significantly higher than 20.0%in patients with PBC,and the difference was statistically significant(P<0.05).However,antimitochodrial antibody M2 subtype(AMA-M2)was mainly detected in patients with PBC,and the positive detection rate was 40.0%,significantly higher than 2.9%in patients with AIH,and the difference was statistically significant(P<0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma glutamyl transferase(GGT)and alkaline phosphatase protein(ALP)in the ALD group were significantly higher than those in the healthy group(P<0.05).ALT level of patients with AIH was higher than that of patients with PBC,and the levels of AST,GGT and ALP were lower than those of patients with PBC,the differences were statistically significant(P<0.05).Conclusion Serum autoantibody detection has significant application value in the clinical diagnosis of ALD in patients with abnormal liver function,and can be applied to the early screening of the disease.In addition,combined with liver function index detection,more accurate diagnosis can be obtained.