抗着丝点抗体在原发性胆汁性肝硬化中的意义  

Significance of anticentromere antibody in primary biliary cirrhosis

作　　者：史旭华[1] 张奉春[1] 张烜[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院风湿免疫科,北京100730

出　　处：《中华风湿病学杂志》2006年第8期485-487,共3页Chinese Journal of Rheumatology

摘　　要：目的研究抗着丝点抗体(ACA)在原发性胆汁性肝硬化(PBC)中的意义。方法用间接免疫荧光法在PBC患者中检测ACA,比较ACA阳性和阴性患者的差别。结果99例PBC患者中ACA阳性53例(53．5%),ACA阳性组发病比ACA阴性组晚[(52．6±1．5)岁vs(46．2±2．0)岁,P=0．012],性别比例和ACA阴性组差异无统计学意义。ACA阳性组出现消化道出血多于ACA阴性组(13．2% vs 0,尸= 0．014),其他临床症状如乏力、瘙痒、黄疸等在两组间差异无统计学意义。虽未达到统计学上的差异,但食管胃底静脉曲张发生率在ACA阳性组高于ACA阴性组(45．8% vs 10．0%,P=0．061)；门静脉宽度、脾大、腹水在两组间差异无统计学意义。肝生化指标中只有总蛋白水平在ACA阳性组低于ACA阴性组[(73．3+ 1．1)g/L vs(78．1+1．7)g/L,P=0．017]。ACA阳性组IgG水平低于ACA阴性组[(15．1±0．6)g/L vs(18．4±1．0) g/L,P=0．006]。核包膜型ANA在ACA阳性组低于ACA阴性组(16．7%vs 50．0%,P=0．002)。结论ACA在PBC患者中阳性率高,ACA阳性的PBC患者更易出现门静脉高压及消化道出血,ACA阳性PBC患者ANA呈现核包膜型者少。Objective To investigate the significance of anticentromere antibody （ACA） in patients with primary biliary cirrhosis （PBC）. Method ACA was detected using indirect immunofluorescence （IIF） in 99 patients with PBC, and the difference was compared between patients with and without ACA. Results Fifty-three patients （53.5%） had ACA in serum. The average age of onset was elder in patients with ACA than in patients without ACA [ （52.6±1.5） vs （46.2＋2.0）, P=-0.012]. There was no significant difference in sex ratio between the two groups. Incidence of gastrointestinal bleeding was higher in patients with than without ACA （13.2% vs 0, P=-0.014）. Difference was not significant in symptoms such as fatigue, pruritus, icterus, etc. Though it didn＇t reach statistically significant, the incidence of esophageal varices was higher in patients with ACA than without ACA （45.8% vs 10.0% respectively, P=-0.061 ）. There was no significant difference in diameter of portal vein, splenomegaly, ascites. Biochemically only serum total protein reached statistical significance between the two groups [ （73.3±1.1）g/L vs （78.1±1.7）g/L respectively, P=0.017]. Patients with ACA had lower serum IgG than ACA negative patients [ （ 15.1 ±0.6） g/L vs （ 18.4±1.0） g/L respectively, P=0.006 ]. Nuclear envelope pattern （NE）, one of the patterns of ANA, was rare in ACA positive group than ACA negative group （16.7% vs 50.0% respectively, P=0.002）. Conclusion The prevalence of ACA is high in patients with PBC. Patients with ACA have high risk of oesophageal varices and gastrointestinal bleeding. Nuclear envelope pattern of ANA is rare in patients with ACA.

关 键 词：肝硬化 胆汁性 荧光免疫测定 抗着丝点抗体 

分 类 号：R575.2[医药卫生—消化系统] R446.62[医药卫生—内科学]