自身抗体谱在原发性胆汁性肝硬化诊断中的作用  

The significance of antoantibody profile in the diagnosis of primary biliary cirrhosis

作　　者：卢建溪[1] 钱师宇[2] 王强[1] 舒欣[3] 李刚[3] 

机构地区：[1]中山大学附属第三医院疫苗研究所,广东广州510630 [2]暨南大学医学院,广东广州510632 [3]中山大学附属第三医院感染科,广东广州510630

出　　处：《中国热带医学》2010年第11期1310-1312,共3页China Tropical Medicine

基　　金：国家高技术研究发展计划(863计划)(No.2007AA021002);广东省自然科学基金资助项目(No.7001521);广东省科技计划资助项目(No.2008B030301101)

摘　　要：目的分析原发性胆汁化肝硬化(PBC)患者的自身抗体谱和免疫功能,探讨其对PBC的诊断价值。方法用免疫印迹法检测107例PBC、100例疾病对照组和30例健康体检者血清中的抗线粒体抗体(AMA)M2亚型、AMAM2-3E(BPO)、抗Spl00抗体、抗gp210抗体、抗肝肾微粒体1型(LKM-1)抗体、抗早幼粒细胞性白血病(PML)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 1.AMA-M2、AMAM2-3E(BPO)、抗Spl00抗体、抗PML抗体、抗gp210抗体对PBC诊断的敏感性、特异性分别为74.7%、90.2%,86.9%、95.1%,32.7%、97.1%,27.1%、97.5%,39.3%,98.3%。未检测到抗LKM-1抗体、抗LC-1抗体、抗SLA/LP抗体。2.在118例疾病对照组中AMA-M2、AMAM2-3E(BPO)、抗Spl00抗体、抗PML抗体、抗gp210抗体检出率分别为16%、11%、3%、1%、3%,未检测到抗LKM-1抗体、抗LC-1抗体、抗SLA/LP抗体。在正常对照组上述8种抗体的检出率均为0。3.AMA-M2呈阳性的患者(n=97)比呈阴性的患者(n=10)有更加严重的疾病。这可通过更加严重的组织学变化和更高的IgG,IgM和ALP平均值看出;抗gp210抗体呈阳性的患者肝功能衰竭发生率明显高于呈阴性的患者(P<0.05)。结论 PBC患者血清中可检测到多种自身抗体,其中抗Spl00抗体、抗PML抗体、抗gp210抗体在PBC诊断中特异性高,可协助诊断PBC。Aim To exploret the significance of antoantibody profile for diagnosis of in primary biliary cirrhosis （PBC）. Methods There 107 PBC patients , 100 disease controls and 30 healthy persons were investigated for anti-AMA M2, anti- AMA M2-3E（BPO）,anti- Spl00,anti- gp210,anti- LKM-1 ,anti- PML,aAnti- LC-land anti- SLA/LP by EUROLine-WB. Results The sensitivity of detection of anti-AMA M2, anti-AMA M2-3E （BPO）, anti- Spl00, anti- gp210 and anti- PML for PBC patients were 74.7% ,90.2% ,86.9% ,95.1% ,32.7% ;the specificity was 97.1% ,27.1% ,97.5% ,39.3% ,98.3% respectively. The anti-LKM-1 ,anti-LC-1 and anti-SLA./LP were not detecded in PBC patients. The detectin rates of anti- AMA M2, anti-AMA M2-3E （BPO）, anti- Sp100, anti-gp210 and anti-PML were 16%, 11%, 3%, 1%, 3% of disease controls respectively. The anti-LKM-1,anti-LC-1 and anti-SLA/LP were not detecded. Patients positive for AMA M2 had signiticandy more severe disease compared to those negative for AMA M2. The incidence rate of liver function failure in anti-gp210 positive patients was highly than anti-gp210 negative patients （P〈0.05）. Conclusion Several autoantibodies can be detected in PBC patients.The specificity of anti-Sp100,anti-gp210 and anti-PML seem to be higher for PBC detection and they may be helpful for diagnosis of PBC.

关 键 词：自身抗体 原发性胆汁性肝硬化 免疫印迹法 

分 类 号：R575.22[医药卫生—消化系统]