抗核包膜抗体、抗多核点抗体和抗线粒体抗体．M2型的联合检测在干燥综合征和原发性胆汁性肝硬化中的临床意义  

Clinical value of combined detection of anti-nuclear envelope protein antibody, anti-soluble acid resistant nudeoprotein and anti-mitochondrial antibody M2 subtype in diagnosis sjogren syndrome and primary biliary cirrhosis

作　　者：彭丽萍[1] 徐胜前[1] 肖会[1] 蔡静[1] 徐建华[1] 

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022

出　　处：《中国综合临床》2015年第1期42-46,共5页Clinical Medicine of China

摘　　要：目的探讨抗核包膜抗体（gp210）、抗多核点抗体（sp100）和抗线粒体抗体M2型（AMA）的联合检测在干燥综合征（SS）和原发性胆汁性肝硬化（PBC）中的临床意义。方法选择241例确诊为弥漫性结缔组织病（Car）的住院患者，采用间接免疫荧光法测定其外周血gp210抗体、spl00和AMA—M2抗体。结果（1）241例CTD患者中AMA—M2抗体、抗sp100、抗gp210阳性率分别为10．4％（25／241）、3．3％（8／241）、2．9％（7／241）。（2）所有241例CTD患者中，SS16例（SS组），SS重叠PBC5例（SS重叠PBC组），PBC17例（PBC组），AMA-M2抗体（x2=6．584，P=0．03）和抗gp210（x2=8．735，P〈0．01）阳性率在3组间比较，差别有统计学意义，抗sp100阳性率在3组间比较差异无统计学意义（X2=3．343，P=0．18）。（3）抗gp210和抗sp100任一阳性在ss、SS重叠PBC和PBC组中的阳性表达分别为3例、4例、4例；3种自身抗体中任意一个阳性在三组患者中的阳性表达分别为8例、5例、13例。（4）241例CTD患者AMA．M2阳性和阴性两组肝损害实验室指标比较显示，血清ALB（t=3．858，P〈0．0001）、TSB（t=5．473，P〈0．0001）、ALT（t=2．235，P=0．026）、AKP（t=3．141，P=0．002）和γ-GT（t=2．317，P=0．021）在两组间比较差异均有统计学意义（P均〈0．05）；抗sp100阳性和阴性两组间仅血清TSB比较差异有统计学意义（t=7．892，P〈0．0001）；抗gp210阳性和阴性两组间仅血清AKP比较差异有统计学意义（t=2．451，P=0．015）。结论抗gp210、抗spl00和M2型AMA的阳性率在SS重叠PBC的患者中均为最高，且与胆汁淤积有关，三者联合检测可提高敏感性，抗sp100和抗gp210对AMA阴性的SS重叠PBC患者的诊断具有一定的意义。Objective To investigate the clinical significance of anti-nuclear envelope protein antibody （ gp210 ）, anti-soluble acid resistant nucleoprotein （ sp 100 ） and anti-mitoehondrial antibody M2 subtype （ AMA- M2） in sjogren syndrome （SS） and primary biliary cirrhosis （PBC）. Methods A total of 241 hospitalized patients diagnosed with connective tissue disease （CTD） were recruited. Anti-gp210, anti-spl00 and AMA-M2 were detected by indirect immunofluorescenee. Results （ 1 ） Positive rate of AMA-M2, anti-spl00 and anti- gp210 in 241 cases CTD patient were 10. 4% （25/241） ,3.3% （8/241） and 2. 9% （7/241） respectively. （2） There were 16 cases with SS,5 cases with SS-PBC overlap syndrome and 17 cases with PBC in 241 patients with CTD. Distinction among groups of PBC, SS, SS overlapping PBC of positive incidence of AMA-M2 antibody （ X2 = 6. 584 ,P = 0. 03 ） and anti-gp210 （X2 = 8.735, P 〈 0. 01 ） were significantly different, while there was no apparent difference about positive rate of anti-splO0 among the three groups （ X2 = 3. 343, P = O. 18 ）. （ 3 ） Positive expression of either antibody of anti-gp210 or anti-spl00 in the three groups of SS, SS overlapping PBC, PBC were 3 cases,4 cases,4 cases respectively. The positive rates of any of three autoantibodies in three groups of were 8 cases ,5 cases, 13 eases respectively. （4） There were significant difference in terms of serum ALB （t =3.858,P〈0.000 1）,TSB（t =5.473,P〈0.000 1）,ALT（t =2.235,P=0.026）,AKP（t =3.141,P =0. 002） and γ-GT（t =2. 317 ,P =0. 021 ） in liver damaged patients of all CTD between AMA-M2 positive and negative patients（ P 〈 0. 05 ）. However, serum TSB in anti-spl00 positive and negative patients were differed （t = 7. 892 ,P 〈 0. 000 1 ）. Serum AKP was different between anti-gp210 positive and negative patients（ t = 2. 451, P = 0. 015 ）. Conclusion Positive rate of anti-gp210, anti-spl00 and AMA-M2 are the highest in patients with SS overlap of the PBC

关 键 词：抗gp210 抗sp100 AMA-M2 干燥综合征 原发性胆汁性肝硬化 

分 类 号：R575.2[医药卫生—消化系统]