肝病相关抗体和生化检测指标在自身免疫性肝炎诊断中的意义  

Significance of liver disease associated antibodies and biochemical detection in the diagnosis of patients with autoimmune hepatitis

作　　者：王晓燕[1] 李娇[1] 石启洋[2] 李冰[1] 

机构地区：[1]大连医科大学附属第一医院检验科,辽宁大连116011 [2]大连医科大学附属第二医院检验科,辽宁大连116023

出　　处：《国际检验医学杂志》2017年第8期1038-1039,1042,共3页International Journal of Laboratory Medicine

摘　　要：目的进一步探索自身抗体和生化检测指标在自身免疫性肝炎(AIH)诊断中的价值,为临床诊断提供实验室依据。方法选取AIH患者为AIH组(n=35)、病毒性肝炎患者为病毒性肝炎组(n=30,包括9例甲型肝炎,15例乙型肝炎,6例丙型肝炎),另选取33健康体检者作为健康对照组(n=33),采用间接免疫荧光法检测抗核抗体(ANA)、抗平滑肌抗体(ASMA)、抗线粒体抗体(AMA),免疫印迹法检测抗可溶性肝抗原/肝胰抗原(SLA/LP)、抗肝细胞浆抗体(LC-1)、抗肝肾微粒体抗体(LKM)、抗线粒体抗体M2亚型(AMA-M2)和全自动生化分析仪检测生化指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、总胆红素(T-BIL)、直接胆红素(D-BIL)、总胆汁酸(TBA)。结果ANA、ASMA、AMA、AMA-M2在AIH组中检测阳性率显著高于病毒性肝炎组和健康对照组,且差异具有统计学意义(P<0.05)。ALP、GGT在AIH组中显著高于其他两组,且差异具有统计学意义(P<0.05)。D-BIL在病毒性肝炎组显著高于其他两组,且差异具有统计学意义(P<0.05)。结论结合自身抗体和实验室生化检测能够帮助临床对AIH做出诊断。Objective To explore the value of autoantibodies and biochemical markers in the diagnosis of autoimmune hepatitis（AIH）,and to provide the basis for clinical diagnosis.Methods AIH patients as AIH group（n=35）,viral hepatitis as viral hepatitis group（n=30,including 9cases of hepatitis A,15 cases of hepatitis B and 6cases of hepatitis C）,the other 33 healthy volunteers were selected as healthy control group,indirect immunofluorescence assay was used to detect ANA,ASMA,AMA.Western blot was used to detect SLA/LP,LC-1,LKM,AMA-M2 and biochemical examination means ALT,AST,ALP,gamma-GT,T-BIL,DBIL,TBA.Results The test results of autoantibodies were tested by chi square test.The positive rate of ANA,ASMA,AMA and AMA-M2 in AIH group was significantly higher than that in viral hepatitis group and healthy control group（P〈0.05）.The results of biochemical test by rank sum test,ALP,gamma-GT in the AIH group was significantly higher than the other two groups（P〈0.05）.The results of D-BIL detection in viral hepatitis group were significantly higher than those in the other two groups（P〈0.05）.Conclusion The combination of autoantibodies and laboratory biochemistry could help clinical diagnosis of AIH.

关 键 词：自身免疫性肝炎 肝病相关抗体 生化肝功 

分 类 号：R575.1[医药卫生—消化系统] R446.1[医药卫生—内科学]