161例自身免疫性肝病患者相关自身抗体检测的临床研究  

A survey of auto-antibodies in 161 patients with autoimmune liver diseases

作　　者：谭立明[1] 王园园[2] 李华[1] 明凤[1] 陈娟娟[1] 王外梅[1] 熊金旺[1] 魏明[1] 

机构地区：[1]南昌大学第二附属医院检验科,330006 [2]南昌大学第二临床学院,07级330006

出　　处：《免疫学杂志》2012年第12期1061-1064,共4页Immunological Journal

基　　金：江西省教育厅基金资助项目(GJJ08133);南昌市科技局基金资助项目(2011-ZCSF-YLWSYRKJK-066)

摘　　要：目的探讨自身抗体检测对自身免疫性肝病(AILD)诊断的临床意义。方法 161例自身免疫性肝病[其中自身免疫性肝炎(AIH)68例、原发性胆汁性肝硬化(PBC)41例和原发性硬化性胆管炎(PSC)52例]、276例病毒性肝炎患者和50例健康体检者采用间接免疫荧光法(IIF)检测抗核抗体(ANA)、抗中性粒细胞胞浆抗体(ANCA)、抗平滑肌抗体(SMA)和抗线粒体抗体(AMA)等自身抗体,采用酶联免疫吸附法(ELISA)检测抗MPO抗体,并对其结果进行回顾性分析。结果 161例AILD检测ANA、ANCA、SMA、抗MPO抗体及AMA结果显示其阳性率分别为42.9%、46.6%、29.2%、30.1%、42.2%,与病毒性肝炎及对照组比较,均P<0.01。各种肝病对自身抗体的检测结果显示AIH较高;AIH中ANCA及p-ANCA检出率与其他肝病组及对照组相比,除PSC外P<0.01,有非常显著意义。结论肝病相关自身抗体的联合检测对自身免疫性肝病的检出、诊断、鉴别诊断、临床分型有重要临床价值,对提高自身免疫性肝病在临床上同病毒性肝炎鉴别诊断和指导治疗有着非常重要的意义。The aim of present study is to investigate the clinical significance of auto-antibodies in the diagnosis of autoimmune liver diseases（AILD）.Indirect immunofluorescence was used to detect related auto-antibodies ANA,ANCA,SMA,AMA,etc in sera from 161 AILD（68 AIH,41 PBC,and 53 PSC）,276 various virus hepatitis,and 50 healthy controls.ELISA assay was employed to test anti-MPO antibody.And all the results were analyzed retrospectively.We found that the positive rates of ANA,ANCA,SMA,anti-MPO and AMA in ALID group were 42.9%,46.6%,29.2%,30.1% and 42.2% respectively,which were significant difference as compared with virus hepatitis or control groups（P 0.01）.AIH group presented higher level of auto-antibodies,and the positive rates of ANCA and p-ANCA were markedly different compared with other groups（P 0.01,except PSC）.We concluded that the combined detection of liver disease-related auto-antibodies is important to diagnosis,clinical classification,and therapy of AILD,especially in the differential diagnosis of virus hepatitis.

关 键 词：自身免疫性肝病 抗核抗体 抗中性粒细胞胞质抗体 抗平滑肌抗体 抗线粒体抗体 

分 类 号：R575.1[医药卫生—消化系统]