病毒性肝炎患者抗肝抗原自身抗体的检测与分析  

Detection and analysis of anti-liver antigens autoantibodies in patients with virus hepatitis

作　　者：叶国强[1] 刘香萍[1] 曾东良[1] 黄呈辉[2] 

机构地区：[1]广东省深圳市宝安区人民医院检验科,518101 [2]广东省深圳市宝安区人民医院感染科,518101

出　　处：《检验医学与临床》2012年第21期2659-2661,共3页Laboratory Medicine and Clinic

基　　金：深圳市科技计划项目资助(201003314)

摘　　要：目的分析病毒性肝炎患者中几种抗肝抗原自身抗体的存在状况和临床意义。方法采用酶联免疫吸附试验和免疫印迹法检测941例病毒性肝炎患者和32例自身免疫性肝病患者血清中肝肾微粒抗体Ⅰ型(LKM-1)、肝细胞胞溶质抗原Ⅰ型(LC-1)、可溶性肝抗原(SLA)等自身抗体。结果 941例病毒性肝炎患者中,抗肝抗原自身抗体检测阳性率分别为LKM-1 0.9%(9/941)、LC-1 0.2%(2/941)、SLA 0.0%(0/941),其中153例丙型肝炎患者中,抗肝抗原自身抗体检测阳性率分别为LKM-1 4.5%(7/153)、LC-1 1.3%(2/153)、SLA 0%(0/153);552例乙型肝炎患者中,仅检测出2例(0.4%)LKM-1阳性,在甲型肝炎、戊型肝炎和丁型肝炎中未检测出抗肝抗原自身抗体。在32例自身免疫性肝病患者中,抗肝抗原抗体LKM-1、LC-1和SLA的检出率分别为9.4%、3.1%和9.4%,其中在11例自身免疫性肝炎中,LKM-1、LC-1和SLA阳性率分别为27.3%、9.1%和18.2%。病毒性肝炎患者抗肝抗原自身抗体检出率低,与自身免疫性肝病患者比较,LKM-1和SLA差异有统计学意义(P<0.01)。结论少数丙型病毒性肝炎患者血清中存在多种抗肝抗原自身抗体,对病毒性肝炎患者进行包括抗肝抗原在内的自身抗体检测有助于病毒性肝炎合并自身免疫性肝病的诊断。Objective To analyze the positive incidence and clinical significance of several anti-liver antigens autoantibodies in the serum of patients with virus hepatitis.Methods The serum samples from 941 patients with virus hepatitis and 32 patients with autoimmune liver diseases were detected for anti-liver kidney microsomal antibodies type 1（LKM-1）,liver cytosolic type 1（LC-1）,soluble liver antigen（SLA） and other autoantibodies by ELISA and Western Blotting.Results Of 941 patients with viral hepatitis,9 cases were anti-LKM-1 positive,2 case with positive LC-1,none was positive SLA.Among 153 patients with hepatitis C,the positive rates of LKM-1,LC-1,SLA were 4.5%,1.3%,0.0% respectively.552 patients with hepatitis B,only 2 cases were anti-LKM-1 positive.No anti-liver antigens autoantibodies were detected in patients with hepatitis A,hepatitis D and hepatitis E.As a contrast,the positive ratesof LKM-1,LC-1,SLA in 32 patients with autoimmune liver diseases were 9.4%,3.1%,9.4%,respectively.Of 11 patients with AIH,the positive rates of LKM-1,LC-1,SLA were 27.3%,9.1%,18.2%,respectively.There were statistically significant differences in the positive rates of LKM-1,SLA between viral hepatitis and autoimmune liver diseases（P0.01）.Conclusion There exists many autoantibodies in serum from patients with hepatitis C.The detection of anti-liver antigens autoantibodies are helpful for diagnosis of autoimmune liver diseases and overlap viral hepatitis.

关 键 词：病毒性肝炎 自身免疫性肝炎 自身抗体 肝肾微粒体抗体Ⅰ型 

分 类 号：R512.6[医药卫生—内科学]