自身抗体检测在慢性肝病诊断中的意义  

Significance of autoantibody assay in the diagnosis of chronic liver diseases

作　　者：曾东良[1] 莫宝妹[1] 姜焕好[1] 李艳红[1] 

机构地区：[1]深圳市宝安区人民医院,广东深圳518101

出　　处：《海南医学》2011年第20期117-119,共3页Hainan Medical Journal

摘　　要：目的通过对慢性肝病患者的肝抗原自身抗体的检测,了解病毒性肝炎与自身免疫性肝病(Autoimmune liver diseases)的自身抗体阳性率及其临床意义。方法采用酶联免疫吸附试验(ELISA)和免疫印迹法,对214例长期肝功能异常的慢性病毒性肝病患者(乙肝患者131例,丙肝患者83例)的血液标本进行抗核抗体(ANA)、线粒体抗体(AMA-M2)、抗肝肾微粒体(LKM-1)、抗可溶性酸性核蛋白抗体(Sp-100)、抗核膜糖蛋白210抗体(gp210)、抗肝细胞浆I型抗原抗体(LC-1)和抗可溶性肝抗原抗体(SCA)进行检测,并与32例自身免疫性肝病患者(自身免疫性肝炎11例,原发性胆汁性肝硬化17例,免疫性胆管炎4例)的自身抗体结果进行分析。结果慢性病毒性肝病患者ANA阳性率为14.4%,其中慢性乙型肝炎(CHB)患者ANA阳性率13.7%,慢性丙型肝炎(CHC)患者ANA分别阳性率为15.7%;自身免疫性肝病ANA阳性率为81.6%,自身免疫性肝炎(AIH)、原发性胆汁性肝硬化(PBC)和免疫性胆管炎(PSC)的阳性率分别为81.8%、88.2%、75.0%,与病毒性肝炎比较差异有统计学意义(P<0.01)。CHB患者AMA-M2、LKM-1和LC-1阳性率分别为1.5%、0.8%和0.8%,CHC患者LKM-1阳性率为6.7%;AIH的AMA-M2、LKM-1、LC-1、SLA的检出率分别为18.2%、27.3%、9.1%和18.2%;PBC的AMA-M2、Sp100、gp210、SLA检出率分别为94.1%、29.4%、17.6%和5.9%,阳性率明显高于病毒性肝炎患者,差异有统计学意义(P<0.01)。结论病毒性肝病与自身免疫性肝病可产生重叠并发,一些病毒感染的血清学指标可能掩盖已经存在的自身免疫性肝病,有必要对一些长期肝功能异常的病毒性肝病患者进行自身抗体的检测。Objective To explore the significance and the positive rate of autoantibody in virus hepatitis and autoimmune liver diseases through autoantibody assay in patients with chronic liver diseases.Methods 214 patients of virus hepatitis were selected as group A,including 131 patients of chronic hepatitis B（CHB） and 83 patients of chronic hepatitis C（CHC）.32 patients of autoimmune liver disease were selected as group B,including 11 patients of autoimmune hepatitis（AIH）,17 patients of primary biliary cirrhosis（PBC）,and 4 patients of primary sclerosing cholangitis（PSC）.Patients in both groups were detected for ANA AMA-M2,LKM-1,Sp-100,gp210 LC-1,and SCA through ELISA and Western Blotting.The results were compared between the two groups.Results In group A,the positive rate of ANA was 14.4%,which was13.7% in patients with CHB and 15.7% in patients with CHC.In group B,the positive rate of ANA was 81.6%,which was 81.8%,88.2%,75.0% in patients with AIH,PBC,PSC,respectively.,There was statistically significant differences in the positive rate of ANA between group A and group B（P〈0.01）.The positive rate of AMA-M2,LKM-1,LC-1 in patients with CHB were 1.5%,0.8%,0.8%,respectively,and that of LKM-1 in patients with CHC was 6.7%.The positive rate of AMA-M2,LKM-1,LC-1,SLA in patients with AIH were 18.2%,27.3%,9.1%,18.2%,respectively,and that of AMA-M2,Sp100,gp210,SLA in patients with PBC were 94.1%,29.4%,17.6%,5.9%,respectively.Conclusion Parameters of autoimmune liver disease might be covered by some indices existed in the infected serum.Therefore,it is necessary to perform autoantibody assay in patients with virus liver diseases.

关 键 词：病毒性肝炎 自身免疫性肝病 自身免疫性抗体 

分 类 号：R512.6[医药卫生—内科学]