原发性胆汁性肝硬化患者血清相关自身抗体检测及其临床意义  

Clinical Significance of Serum Autoantibodies Tests for Patients with Primary Biliary Cirrhosis

作　　者：郭婧婧[1] 金燕[1] 张运丽[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《医学临床研究》2006年第9期1425-1427,共3页Journal of Clinical Research

摘　　要：【目的】探讨原发性胆汁性肝硬化(PBC)患者血清自身抗体的临床意义。【方法】对248例不明原因的肝功能持续异常患者应用间接免疫荧光法(IIF)进行血清抗核抗体(ANA)、抗平滑肌抗体(SMA)检测,应用免疫斑点法(Euroassay)进行抗肝肾微粒体-1(LKM-1)、抗肝溶质抗原-1(LC-1)、抗可溶性肝抗原/抗肝胰抗原(SLA/LP)、抗线粒体M2型(AMA-M2)检测,并结合生化指标及免疫球蛋白指标进行分析。【结果】248例不明原因的肝功能持续异常患者中,PBC 51例,占20.5%,其余197例原因不明。PBC患者的AMA-M2抗体均为阳性,ANA阳性32例占62.7%。ANA的主要荧光模式为核膜型和核点型。PBC患者ALP、GGT及免疫球蛋白M高于乙型肝炎肝硬化患者。在51例PBC中,4例表现为自身免疫性肝病重叠综合征,其中1例抗SLA/LP阳性,提示PBC与自身免疫性肝炎(AIH)3型重叠,1例抗LKM-1阳性,提示PBC与自身免疫性肝炎(AIH)2型重叠,2例ANA,SMA抗体阳性,提示PBC为与自身免疫性肝炎(AIH)1型重叠综合症。【结论】自身抗体及肝抗原抗体的检测对PBC诊断有重要意义;PBC患者存在PBC/AIH重叠综合征;对原因不明的肝功能异常的患者进行肝抗原自身抗体的检测有助于临床诊断。[Objective]To explore the clinical significance of serum autoantibodies for Primary Biliary Cirrhosis（PBC）. [Methods]Anti-nuclear （ANA）,anti-smooth muscle antibodies （SMA） were detected using immunofluorescent assays, autoantibody of liver antigens LKM-1, LC-1 SLA/LP and AMA-M2 were detected by an immune blotting assay for 248 patients with abnormal liver functions of unknown cause, and these results were analyzed according to their biochemical results and immune globulin. [Results]Of the 248 patients with abnormal liver functions of unknown cause, 51 （20.5 %） were diagnosed as PBC, the remaining 197 did not find causes. Of 51 PBC cases, AMA-M2 positive rate was 100%, ANA positive rate was 62.7%（32/51）, Nuclear membrane and nuclear dots were two main fluorescent patterns of ANA. Immune globulin M, ALP and GGT in PBC patients were significantly higher than those of hepatitis B related liver cirrhosis patients. In 4 autoimmune liver disease overlap syndromes among 51 PBC patients, one was SLA/LP positive, indicated as AIH type Ⅲ and PBC overlapping, 1 was KLM-1 positive showing AIH type Ⅱ overlapping PBC, and 2 had ANA, SMA positive and were identified as AIH type 1 overlapping PBC. [Conclusion]Detections of ANA, SMA and autoantibody of liver antigens are useful for clinically identifying PBC. Autoimmunity overlap syndrome is found in PBC. The autoantibody detection of liver antigens for patients with abnormal liver functions of unknown cause will be helpful for clinical diagnosis.

关 键 词：肝硬化 胆汁性/血液 自身抗体/A液 

分 类 号：R575.22[医药卫生—消化系统]