抗线粒体抗体阴性原发性胆汁性肝硬化患者的临床及免疫学特征分析  

Clinical and immunologic characteristic analysis of primary biliary cirrhosis with anti mitochondrial antibody negative

作　　者：周磊[1] 谢军[1] 

机构地区：[1]上海市静安区中心医院,上海200040

出　　处：《现代中西医结合杂志》2008年第20期3084-3086,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨抗线粒体抗体(AMA)阴性原发性胆汁性肝硬化(PBC)患者的临床及免疫学特征。方法对1993年1月—2007年1月临床及病理确诊的83例PBC患者进行回顾性研究分析,通过对比AMA阴性及AMA阳性患者的一般资料、病程、临床表现、免疫学、生物化学及病理学特征来研究AMA阴性PBC的临床及免疫学特征。结果83例经临床及病理诊断确诊为PBC的患者中14例患者血清AMA/AMA-M2检测结果呈阴性,AMA阴性的PBC患者其抗核抗体(ANA)的阳性率(86%)显著高于AMA阳性的PBC患者(35%)(P=0.0042),抗平滑肌抗体(ASMA)的阳性率(43%)也显著高于AMA阳性的PBC患者(6%)(P=0.035)。AMA阴性患者和AMA阳性患者之间在年龄、性别比例、临床表现、肝功能试验、组织学表现以及病理分期方面无显著性差异。结论AMA阴性PBC患者血清ANA及ASMA阳性率较高,但AMA阴性PBC患者与AMA阳性患者在临床表现、生化改变、肝脏病理进展及预后方面无显著性差异。Objective It is to discuss clinical and immunological characteristics of primary biliary cirrhosis （PBC） with anti mitochondrial antibody （AMA） negative. Methods The data of 83 PBC patients who had been final diagnosed through clinic and pathology from January 1993 to January 2007 were analyzed with Retrospective Studies. The clinical and immunological characteristics of PBC with AMA negative were studied through contrasting general data, pathogenesis, clinical situation, immunology characteristics, biochemistry characteristics and pathology characteristics between AMA negative and AMA positive patients. Results In 83 PBC patients who had been final diagnosed through clinic and pathology, serum AMA/AMAM2 detection results of 14 cases were negative. The positive rate of anti nuclear antibody （ANA） in AMA negative patients （86 % ） was significantly higher than that in AMA positive patients （35 % ） （P = 0. 0042）. The positive rate of anti smooth muscle antibody （ASMA） in AMA negative patients （43 % ） was significantly higher than that in AMA positive patients （6 % ） （ P = 0. 035）. There was no significant difference on age, sex ratio, clinical situation, liver function tests, histological situation and pathological staging between AMA negative patients and AMA positive patients. Conclusion The positive rate of serum ANA and ASMA in PBC patients with AMA negative are relatively higher, but there is no significant difference on clinical situation, biochemical changes, liver pathology progress and prognosis between AMA negative patients and AMA positive patients.

关 键 词：原发性胆汁性肝硬化 抗线粒体抗体 抗平滑肌抗体 抗核抗体 

分 类 号：R575.2[医药卫生—消化系统] R587.1[医药卫生—内科学]