CD4/CD8比值联合自身抗体检测诊断原发性胆汁性肝硬变的临床价值分析  

Analysis of the clinical value of CD4/CD8 ratio combined with autoantibodies detection in diagnosis of primary biliary cirrhosis

作　　者：王大刚[1] 赛汗格日勒 华菲[1] 何叶莉 郭桐生[1] 朱剑功[1] 

机构地区：[1]解放军302医院临床检验医学中心,北京100039

出　　处：《西北国防医学杂志》2015年第12期799-802,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:分析T淋巴细胞亚群CD4/CD8比值与自身抗体联合检测诊断原发性胆汁性肝硬变(PBC)的临床价值。方法:CD4/CD8比值通过BD流式细胞仪检测T淋巴细胞亚群得到,同时采用欧蒙免疫印迹法检测血清自身抗体。检测结果通过多因素Logistic回归和ROC曲线进行分析。结果:血清自身抗体AMA-M2、BPO和CD4/CD8比值在PBC患者中高表达,显著高于自身免疫性肝炎(AIH)组和对照组(P<0.01);AMA-M2和BPO阳性患者的CD4/CD8均显著高于阴性患者(P<0.01);Logistic回归分析表明,AMA-M2[OR=14.679,95%CI(3.016,71.447)]、BPO[OR=16.362,95%CI(5.752,46.544)]和CD4/CD8[OR=2.459,95%CI(1.292,4.679)]都是PBC的危险因素;ROC曲线分析结果显示AMA-M2、BPO和CD4/CD8对PBC的诊断具有一定的临床价值,其曲线下面积分别为0.833、0.866和0.737,联合检测曲线下面积为0.945。结论:PBC患者的血清自身抗体AMA-M2、BPO阳性率显著升高,且伴有CD4/CD8比值的显著升高。3个指标的联合检测可提高临床对于PBC的诊断效率。Objective：To analyze the clinical value of T lymphocyte subgroups CD4/CD8 ratio combined with autoantibodies in diagnosis of primary biliary cirrhosis.Methods：The CD4/CD8 ratio were obtained from T lymphocyte subgroups detected by BD flow cytometer.The serum autoantibodies were detected by EUROBlot.The results were analyzed by multivariable logistic regression and ROC curve.Results：The levels of serum autoantibodies AMA-M2,BPO and CD4/CD8 ratio were significantly higher in the primary biliary cirrhosis（PBC）patients than those in the autoimmune hepatitis（AIH）group and control group（P〈0.01）.The CD4/CD8 ratio of AMA- M2 and BPO positive patients were significantly higher than those of the negative patients（P〈0.01）.The results of logistic regression showed that AMA-M2[OR=14.679,95%CI（3.016,71.447）],BPO[OR=16.362,95%CI（5.752,46.544）]and CD4/CD8 [OR=2.459,95% CI（1.292,4.679）]were risk factors of PBC.The results of ROC curve analysis showed that AMAM2,BPO and CD4/CD8 ratio had certain clinical value for the diagnosis of PBC.The area of under curve were 0.833,0.866 and 0.737 respectively,and 0.945 together.Conclusion：The positive rate of serum autoantibodies AMA- M2 and BPO were significantly elevated in patients with PBC,and meanwhile the CD4/CD8 ratio were also significantly increased.The combined detection of the three indicators can improve the clinical diagnostic efficiency of PBC.

关 键 词：肝硬变 自身免疫性肝炎 重叠综合征 自身抗体 CD4/CD8比值 

分 类 号：R575.2[医药卫生—消化系统]