抗SSA和抗SSB抗体在肝病患者的检测及临床意义  

Clinical significance of antibodies to SSA/SSB detection in patients with liver diseases

作　　者：孙丽梅[1] 闫惠平[1] 马胤雪[1] 李艳丽[1] 张海萍[1] 赵丹彤[1] 张欣[1] 王熠[1] 

机构地区：[1]首都医科大学附属北京佑安医院自身免疫性肝病临床研究中心,100069

出　　处：《北京医学》2012年第6期437-440,共4页Beijing Medical Journal

基　　金：北京市自然科学基金(7111004)

摘　　要：目的探讨抗SSA、抗SSB在肝病患者的临床意义。方法对143例抗SSA和(或)抗SSB抗体阳性的肝病患者自身抗体的检出情况及其与疾病的关系进行回顾性分析。结果 143例患者中,126例(88.1%)单一抗SSA阳性,3例(2.1%)单一抗SSB阳性,14例(9.8%)抗SSA、抗SSB均阳性;抗SSA的阳性率显著高于抗SSB(掊2=143,P<0.05)。140例抗SSA阳性患者中,79例(56.4%)抗Ro52阳性,33例(23.6%)抗Ro60阳性,28例(20.0%)两者均阳性。本组患者中,126例(88.1%)抗核抗体(ANA)阳性,ANA滴度为1:320～1:1000和1:100的患者分别为102例(71.3%)、24例(16.8%),差异具有统计学意义(掊2=113.99,P<0.05);17例(11.9%)患者ANA阴性,且均为单一抗SSA阳性者。抗SSA、抗SSB阳性主要见于原发性胆汁性肝硬化(61例,42.7%)、药物性肝损害(22例,15.4%)、自身免疫性肝炎(20例,14.0%)、慢性丙型肝炎(20例,14.0%)和慢性乙型肝炎(15例,10.5%)。143例患者中,13例(9.1%)合并干燥综合征。结论抗SSA和(或)抗SSB不仅见于干燥综合征、原发性胆汁性肝硬化、自身免疫性肝炎等自身免疫性疾病中,还可见于药物性肝损害、病毒性肝炎等非自身免疫性疾病中,提示在肝病患者中出现抗SSA和(或)抗SSB抗体阳性时,应综合考虑其是否合并干燥综合征等结缔组织病,并密切随访,避免误诊漏诊。Objective To investigate the clinical significance of antibodies to SSA/SSB in patients with different liver diseases.Methods The clinical data of 143 patients with liver diseases were retrospectively analyzed,whose antibodies to SSA/SSB were positive.Results Among the 143 patients,126（88.1%） were anti-SSA positive alone,3（2.1%） were anti-SSB positive alone and 14（9.8%） were anti-SSA and anti-SSB both positive.The rate of anti-SSA was significantly higher than anti-SSB（x2 = 143,P 〈0.05）.Of the 140 patients who were anti-SSA positive,79（56.4%） were anti-Ro52 positive,33（23.6%） were anti-Ro60 positive and 28（20.0%） were anti-Ro52 and anti-Ro60 both positive.Among the 143 cases anti-SSA/SSB positive patients,126（88.1%） were ANA positive by IFA,the patients with higher ANA titer（1：320～1：1000）（102/126,71.3%） were significantly more than lower ANA titer（1：100）（24/126,16.8%）（x2 = 113.99,P 〈0.05）.However,there were 17（11.9%） patients who were anti-SSA positive by IB but ANA negative by IFA.Anti-SSA/SSB were seen commonly in primary biliary cirrhosis（n=61,42.7%）,drug induced liver disease（n=22,15.4%）,autoimmune hepatitis（n=20,14.0%）,chronic hepatitis C（n=20,14.0%） and chronic hepatitis B（n=15,10.5%）.Among the 143 patients,13（9.1%） combined with Sjogren syndrome.Conclusions The frequency of anti-SSA/SSB can be detected not only in autoimmune diseases such as Sjogren syndrome,primary biliary cirrhosis,autoimmune hepatitis but also in non-autoimmune liver diseases such as drug induced liver disease and viral hepatitis.The results suggest that doctors should consider liver disease combined with Sjogren syndrome or other connective tissue diseases while the patients with anti-SSA/SSB positive and sequentially follow up them.

关 键 词：抗SSA抗体 抗SSB抗体 抗核抗体 肝病 

分 类 号：R446.6[医药卫生—诊断学]