原发性胆汁性肝硬化自身抗体谱的检测及临床应用  

Determination of autoantibody profile in patients with primary biliary cirrhosis and its clinical application

作　　者：张洋[1] 李永哲[1] 冯雪[1] 包书萌[1] 胡朝军[1] 佟大伟[1] 张蜀澜[1] 张奉春[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科,100032

出　　处：《中华检验医学杂志》2009年第7期760-763,共4页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目（30471617,30640084,30872331）

摘　　要：目的探讨联合检测多种自身抗体在原发性胆汁性肝硬化（PBC）诊断中的价值及临床意义。方法用免疫印迹法分别检测96例PBC患者，100例其他自身免疫性疾病（AID）患者和49名健康体检者血清中的抗线粒体（AMA）-M2亚型抗体、抗3E（BPO）抗体、抗Sp100抗体、抗早幼粒细胞性自血病（PML）抗体、抗gp210抗体、抗肝肾微粒体-1（LKM-1）抗体、抗肝特异性胞质抗体-1（LC-1）、抗可溶性肝抗原／肝胰抗原抗体（SLA／LP）。结果96例PBC患者中AMA—M2、抗3E（BPO）抗体、抗Sp100抗体、抗PML抗体、抗gp210抗体阳性率分别为76．0％、84．4％、32．3％、28．1％、35．4％，而以上5种自身抗体在其他自身免疫性疾病中的阳性率分别为13．0％、9．0％、3．0％、2．0％、1．0％；AMA—M2对PBC诊断的敏感度达76．0％，特异度达87．0％；抗3E（BPO）抗体对PBC诊断的敏感度达84．4％，特异度达91．0％；抗Sp100抗体对PBC诊断的敏感度达32．3％，特异度达97．0％；抗PML抗体对PBC诊断的敏感度达28．1％，特异度达98．0％；抗gp210抗体对PBC诊断的敏感度达35．4％，特异度达99．0％，未检测到抗LKM-1抗体、抗LC-1抗体及抗SLA／LP抗体；抗gp210抗体阳性患者肝功能衰竭的发生率明显高于抗体阴性患者（Х^2=11．17，P〈0．01）。结论PBC患者中可检测到多种自身抗体，自身免疫性肝病自身抗体谱检测对PBC诊断、鉴别诊断、治疗及预后判断均有重要意义。Objective To detect the value of autoantibody profile in primary biliary cirrhosis （PBC）. Methods 96 serum samples of patients with primiary biliary cirrhosis, 100 serum samples of other autoimmune disease and 49 serum samples of healthy were tested for anti- M2, anti-3E （ BPO）, anti-Sp100, anti-PML, anti-gp210, anti-LKM-1, anti-LC-I, anti-SLA/LP by EUROLine. Results The positive of the anti- M2,anti-BPO, anti-Sp100, anti-PML and anti-gp210 for PBC was 76. 0%, 84.4% , 32. 3% , 28. 1% and 35.4% ,respectively. The positive of the anti-M2, anti-BPO, anti-Spl00, anti-PML and anti-gp210 for other autoimmune disease was 13.0% ,9. 0% ,3.0% ,2. 0% and 1.0%, respectively. The sensitivity of the anti- M2 for PBC was 76. 0% ,with specificity of 87. 0%. The sensitivity of the anti-BPO for PBC was 84.4% , with specificity of 91.0% ;the sensitivity of the anti-Sp100 for PBC was 32. 3% ,with specificity of 97.0%. The sensitivity of the anti-PML for PBC was 28.1% ,with specificity of 98.0%. The sensitivity of the antigp210 for PBC was 35.4%, with specificity of 99.0%. Anti-LKM-1, anti-LC-1, anti-SLA/LP positive patients with PBC were not detected ;the incidence rate of liver function failure in anti-gp210 positive serum higher than anti-gp210 negative serum （Х^2 = 11.17, P 〈 0. 01 ）. Conclusions Multiple autoantibodies can be detected in the sera of PBC patients. The detection of autoantibody profile is useful for the diagnosis and differential diagnosis of PBC, and may be helpful for therapy and prognosis of PBC.

关 键 词：肝硬化 胆汁性 自身抗体 免疫印迹法 

分 类 号：R686[医药卫生—骨科学]