dsDNA抗体检测对自身免疫性肝炎的临床意义  

Significance of antibody to double-stranded DNA in autoimmune hepatitis

作　　者：赵艳[1] 闫惠平[1] 檀玉芬[1] 刘妍[1] 马冬梅[1] 冯霞[1] 李伟华[1] 

机构地区：[1]首都医科大学附属北京佑安医院重点实验室,100069

出　　处：《中华微生物学和免疫学杂志》2008年第7期639-642,共4页Chinese Journal of Microbiology and Immunology

基　　金：基金项目：国家自然科学基金资助项目（30570723）;北京市自然科学基金资助项目（7062033）

摘　　要：目的探讨dsDNA抗体对自身免疫性肝炎（autoimmune hepatitis，AIH）的临床意义。方法收集临床诊断为AIH的患者血清43例，采用免疫印迹法检测dsDNA抗体。按dsDNA抗体阳性与否，分为抗体阳性组及抗体阴性组，比较dsDNA抗体阳性组与阴性组临床生化指标及预后的差异。结果43例AIH患者中dsDNA抗体阳性13例（30．23％）。13例dsDNA抗体阳性AIH患者平均天冬氨酸转氨酶（AST）为（647．56±529．77）IU／ml，总胆红素（TBIL）为（10．81±8．08）mg／L，明显高于对照组（P〈0．05），凝血酶原活动度（PTA）为75．72％±30．23％，明显低于对照组（P〈0．05）。dsDNA抗体阳性AIH患者组肝硬化发生率为61．5％（8／13），明显高于对照组（P〈0．05）。对两组患者出现肝硬化的时间作生存分析，发现dsDNA抗体阳性AIH患者发生肝硬化的时间明显短于对照组（P=0．0074）。结论抗dsDNA阳性的AIH患者肝损伤较重，病情进展较迅速，预后较差。Objective To study the significance of antibody to double-stranded DNA （anti- dsDNA） in autoimmune hepatitis（AIH）. Methods Anti-dsDNA were detected by immunological blotting. According to the anti-dsDNA, the patients were separated two groups： anti-dsDNA positive group and anti-dsDNA negative group. The clinical characteristics were compared between anti-dsDNA positive AIH group and negative group. Results Among the 43 serum samples, 13 （30.23%） cases with anti-dsDNA positive were found. The average level of AST（ aspartate aminotransferase） and TBIL（ total bilirubin） were （647.56±529.77） IU/L and （ 10.81±8.08） mg/L, respectively, which was higher than that of the control group （ P〈0.05 ）. PTA（ prothrombin activity） was 75.72% ±30.23%, lower than that of the control group（ P〈0.05）. The liver cirrhosis rate in the anti-dsDNA positive AIH group was 61.5% （8/13）,significantly higher than that of the control group. The time from the onset to liver cirrhosis was significantly shorter in anti-dsDNA positive AIH group than that of control group by the survival analysis and log rank test （ P=0.0074）. Conclusion AIH patients with anti-dsDNA positive generally associate with the serious liver damage, and prognosis is worse.

关 键 词：双链DNA抗体 自身免疫性肝炎 肝硬化 

分 类 号：R446.6[医药卫生—诊断学] R575.1[医药卫生—临床医学]