原发性胆汁性肝硬化血清免疫学检测的临床意义  

Significance of serum autoimmune indexes in diagnosis of primary biliary cirrhosis

作　　者：尧颖[1] 杨晋辉[1] 徐智媛[1] 尤丽英[1] 胥莹[1] 唐映梅[1] 陈学平[1] 李祥金[1] 

机构地区：[1]昆明医学院第二附属医院肝病中心肝胆胰内科,云南昆明650101

出　　处：《胃肠病学和肝病学杂志》2007年第5期417-419,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析PBC患者的自身抗体和免疫功能,探讨其对PBC的诊断价值。方法连续纳入确诊的PBC患者50例,以免疫印迹法检测肝特异性自身抗体,以间接免疫荧光法检测肝非特异性自身抗体,以免疫散射比浊法检测免疫球蛋白和补体,30例行肝穿刺活检组织病理学检查。结果本组PBC患者女性多于男性（41：9）,年龄20-83岁,平均55.9岁±13.2岁。肝特异性自身抗体中AMA-M2阳性最为多见（68%）,其次为GP210抗体（22%）、核点蛋白SP100抗体（14%）、肝肾微粒体1型（LKM-1）抗体（10%）、和肝细胞溶质抗原Ⅰ型（LC-1）抗体（2%）,肝非特异性自身抗体以抗核抗体（ANA）检出率最高（61%）。结论自身抗体,尤其是血清AMA-M2阳性是诊断PBC的重要依据之一,但多种蛋白在PBC病程中均有表达,且临床上有相当比例的AMA-M2阴性PBC患者。其他肝特异性自身抗体如SP100抗体、GP210抗体等以及临床特点和肝穿刺活检对AMA-M2阴性PBC的诊断有重要价值。Objective To investigate the autoantibodies, immunologic function and their diagnostic value in PBC. Method Fifty cases of consecutive PBC patients were enrolled in the study. Liver specific autoantibodies were detected by immunoblotting, non-liver-specific, autoantibodies by indirect immunofiuorescence, and immunoglobulin and complement by nephelometry. Liver biopsies were processed for histopathology in 30 PBC patients. Result Among the patients enrolled in this study, 9 males and 41 females, the age ranged from 20 to 83 years with the mean age （55.9 ± 13.2） years. The positivity rates of liverspecific autoantibodies were as follows： AMA-M2 68% , nuclear dot-associated protein GP210 antibody 22% ,SP100 antibody 14% , liver-kidney microsomes type 1 （LKM-1） antibody 10% , and liver cytosolic antigen type 1 （LC-1） antibody 2%. The positivity rate of non-liver-specific autoantibody antinuclear antibody （ANA） was 61%. Conclusion Autoantibodies are present in PBC patients, and serum AMA-M2 is one of the most important indexes in the diagnosis of PBC. However, other proteins also express in the course of disease. There are a portion of AMA-M2-negative PBC patients in clinics. Therefore, other liver-specific autoantibodies such as SP100 anti- body, GP210 antibody are important in the diagnosis of AMA-M2-negative PBC, and the clinical features as well as liver biopsy are also invaluable.

关 键 词：胆汁性肝硬化 原发性 自身抗体 诊断 

分 类 号：R575.2[医药卫生—消化系统]