自身免疫性肝病与病毒性肝病患者自身抗体和肝功能的相关性研究  

Study on correlation of autoantibody and liver function in autoimmune liver diseases and viral hepatitis patients

作　　者：周泉[1] 李艳[1] 周心房[1] 

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060

出　　处：《职业与健康》2016年第1期69-72,共4页Occupation and Health

基　　金：武汉大学人民医院国家临床重点专科建设项目(财社[2010]305号)

摘　　要：目的探讨自身免疫性肝病(ALDS)患者与病毒性肝病患者检测自身抗体与肝功能的临床价值。方法应用免疫印迹法和间接免疫荧光法检测自身免疫性肝病、病毒性肝病患者和健康检查者血清中的自身抗体,并测定每位患者的肝功能。结果 ALDS组中抗核抗体(AVA)的阳性检出率(88.2%)明显高于病毒性肝病组(15.9%),差异有统计学意义(P<0.05),在检测肝病自身抗体时ALDS组中线粒体抗体(AMA)的检出率为65.7%,明显高于病毒性肝病组的0.6%(P<0.01)。在肝病自身抗体中自身免疫性肝炎(AIH)的抗平滑肌抗体(SMA)阳性率为47.2%,明显高于原发性胆汁性肝硬化(PBC)组的17.1%,但PBC组的AMA阳性率为95.7%,则显著高于AIH组。AIH的ANA的核型主要为颗粒型;PBC为着丝点型;原发性硬化性胆管炎(PSC)为核膜型;病毒性肝病则未见特定荧光核型。在ALDS组与病毒性肝病组中,丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)和谷氨酰转肽酶(GGT)活力均升高,差异有统计学意义(P<0.05),但免疫球蛋白(Ig G)差异无统计学意义(P>0.05)。结论自身抗体对ALDS与病毒性肝病患者的诊断与鉴别有重要意义,ALDS的诊断可结合自身抗体检测与肝功能的结果以提高诊断的准确性。[Objective]To explore the clinical value of detection autoantibody and liver function among autoimmune liver diseases（ ALDS） and viral hepatitis patients. [Methods]The autoantibodies in ALDS, viral hepatitis patients and healthy examiner were tested by indirect immunofluorescence（ IIF） and immunoblotting methods. The liver function of each patient was detected.[Results]The positive detection rate of antinuclear antibodies（ AVA） in ALDS group（ 88.2%） was significantly higher than that in viral hepatitis group（ 15.9%）, the difference was statistically significant（ P〈0.05）. In detecting the antibodies of liver diseases,the positive rate of antimitochondrial antibodies（ AMA） in ALDS group（ 65.7%） was higher than that in viral hepatitis group（ 0.6%）（ P〈0.01）. The positive rate of antismooth muscle antibodies（ SMA） of autoimmune hepatitis（ AIH）（ 47.2%） was higher than that in primary biliary cirrhosis（ PBC） group（ 17.1%）, but the positive rate of AMA in PBC group（ 95.7%） was significant higher than that in AIH group. The karyotype of AVA of AIH was granular type, PBC was centromere type, primary sclerosing cholangitis（ PSC） was nuclear membrane, and virus hepatic disease did not exist specific fluorescence karyotype. The vitalities of ALT,AST,ALP and GGT in ALDS and viral hepatitis groups all increased, and the differences were statistically significant（ P 0.05）, but the difference of Ig G was not statistically significant（ P 〉0.05）. [Conclusion]Autoantibody is important in the diagnosis and identification of ALDS and viral hepatitis. The diagnosis of ALDS can be combined with the detection of autoantibody and liver function results to improve the accuracy of diagnosis.

关 键 词：自身免疫性肝病 病毒性肝病 自身抗体 

分 类 号：R183[医药卫生—流行病学]