自身抗体在自身免疫性肝病诊断中的价值  

Value of autoantibodies in diagnosis of autoimmune liver disease

作　　者：李琳彬[1] 郭广波 余焰 刘力瑜[1] 陈忠余[1] 

机构地区：[1]重庆市中医院检验科,400021

出　　处：《检验医学与临床》2014年第15期2051-2052,2056,共3页Laboratory Medicine and Clinic

基　　金：重庆市卫生局资助项目(2013-2-008)

摘　　要：目的探讨自身抗体谱分析在自身免疫性肝病(ALD)诊断中的价值。方法回顾性分析864例肝病患者中各类自身免疫性肝病的分布、年龄、性别特征及自身抗体(ANA)、肝抗原自身抗体阳性率。结果 864例患者中,病毒性肝炎763例、自身免疫性肝炎(AIH)51例、原发性胆汁性肝硬化(PBC)37例、原发性硬化性胆管炎(PSC)4例和重叠综合征(OS)9例。ALD多见于40岁以上女性。病毒性肝炎组ANA、抗平滑肌肌动蛋白抗体(ASMA)、抗肝肾微粒体抗体1型抗体(LKM-1)的阳性率分别为23.3%、4.6%、1.0%;AIH组ANA、ASMA、抗LKM-1、抗肝细胞溶质抗原1型抗体(抗LC-1)、抗可溶性肝抗原/肝胰抗原抗体(抗SLA/LP)、抗中性粒细胞胞浆抗体(ANCA)的阳性率分别为78.1%、70.6%、7.8%、5.9%、9.8%、29.4%;PBC组ANA、ASMA、抗线粒体抗体亚型M2(AMA-M2)的阳性率分别为83.9%、37.8%、86.5%。结论自身抗体检测是诊断自身免疫性肝病的必要条件,但这些自身抗体也可见于病毒性肝炎。Objective To study the value of autoantibody analysis on diagnosis of autoimmune liver disease . Methods To analyze retrospectively characteristics of distribution ,age and gender for various kinds of disease and positive rate for ANA （Antiudear antibodoy ） and auto-antibody of liver antigens in 864 patients with liver disease .Results 85 patients were included in this study ,among them 763 patients with Viral hepatitis ,51 with Aautoimmune hepatitis（AIH） ,37 with primary biliary cirrhosis（PBC） ,4 with primary sclerosing cholangitis（PSC） ,9 with overlap syndromes（OS） ,ALD mainly affected female patients above 40 years old .The positive rates of ANA ,ASMA（anti-smooth muscleantibody） ,anti-LKM-1 were 23 .3% ,4 .6% ,1 .0% in Viral hepatitis .The positive rates of ANA ,AS-MA ,anti-LKM-1 ,anti-LC-1 ,anti-SLA/LP ,ANCA （anti-neutrophilcytoplasmic antibodies ） were 78 .1% ,70 .6% , 7 .8% ,5 .9% ,9 .8% ,29 .4% in AIH .The positive rates of ANA ,ASMA ,AMA-M2（anti-mitochondrial antibody type 2） were 83 .9% ,37 .8% ,86 .5% in PBC .Conclusion Autoantibodies detection is essential for diagnosis of autoimmune liver disease ,but there are autoantibodies in non-autoimmune liver disease .

关 键 词：自身抗体 自身免疫性肝炎 原发性胆汁性肝硬化 原发性硬化性胆管炎 

分 类 号：R575[医药卫生—消化系统]