不同肝病患者抗肝抗原自身抗体的研究  

Study on anti-liver antigens in Chinese patients with different liver diseases

作　　者：阎惠平[1] Winfried Stcker 贺立香[1] 张世斌[1] 李秀惠[1] 黄德庄[1] 赵春惠[1] 

机构地区：[1]北京佑安医院北京市肝炎研究所 [2]德国EUROIMMUN实验免疫制品有限公司

出　　处：《中华微生物学和免疫学杂志》2002年第5期522-525,共4页Chinese Journal of Microbiology and Immunology

摘　　要：目的　观察我国不同类型肝病患者中几种抗肝抗原自身抗体的存在状况 ;探讨自身免疫性肝脏疾病的自身抗体特征。方法　由 14 12例标本中选择 2 30例肝功能异常患者分为 5组 :①自身免疫性肝病组 4 2例 :自身免疫性肝炎 (AIH) 18例、原发性胆汁性肝硬化 (PBC) 2 1例、原发性硬化性胆管炎 (PSC) 3例。②HAV组 2 3例 ;③HBV组 70例 ;④HCV组 35例 ;⑤非甲～戊型肝炎组 6 0例。用间接免疫荧光、Westernblot、酶免疫条带技术等分别检测抗核抗体 (ANA)、抗线粒体抗体(AMA)、平滑肌抗体 (SMA)、肝肾微粒抗体Ⅰ型 (LKM 1)、肝细胞胞溶质抗原Ⅰ型 (LC 1)、可溶性肝抗原 (SLA) 肝胰抗原 (LP)和AMA M2亚型 ,以及SS A、SS B、dsDNA等多种抗体。结果　 14 12例中诊断AIH、PBC和PSC者分别为送检标本的 1.2 7% ,1.4 9%和 0 .2 1%。 2 30例血清中 2例LKM 1阳性和 2例SLA LP阳性 ,分别见于AIH和HCV感染者。PBC患者AMA和M2全部阳性 ;其ANA以核膜型为主 (7 14 ) ;AIH患者ANA抗体未见特定的荧光类型 ,而抗 Actin仅见于AIH者。非甲～戊组 4例AMA和M2阳性 ,3例SMA高滴度阳性 ,4例出现SS A、SS B或dsDNA等抗体。结论　肝抗原抗体和ANA及AMA分型的检测有助于自身免疫性肝病和重叠多种免疫性肝病的诊断 ;非甲～戊型肝炎诊断时应?Objective To study several anti liver antigens in Chinese patients with different liver diseases and to discuss the characteristics of autoantibodies in autoimmune liver diseases. Methods From 1 412 patients, detected by IIF initialy, 230 patients with abnormal ALT were chosen and divided into 5 groups: ① autoimmune diseases group, 42 cases: 18 with autoimmune hepatitis(AIH), 21 with primary biliary cirrhosis (PBC), 3 with primary sclerosing cholangitis(PSC); ② HAV group, 23 cases; ③ HBV group, 70 cases; ④ HCV group, 35 cases; ⑤ Non A-E group, 60 cases. First, ANA, AMA, SMA and liver kidney microsomal antibody (LKM 1) were tested by indirect immunofluorescence. Then, LKM 1, LC 1, soluble liver antigen/liver pancreas (SLA/LP) and subtype of AMA (M2) as well as ANA profile were detected by Western blot, EUROASSAY respectively. Results Among 1 412 cases, those diagnosed as AIH, PBC and PSC accounted for 1.27%, 1.49% and 0.21% of the specimens tested. 2/230 with LKM 1 and 2/230 with SLA/LP were AIH, AIH/PSC overlap syndromes and HCV infection, respectively. AMA and M2 positive were found in all PBC, and its main ANA pattern was nuclear membrane. No specific ANA pattern were seen in AIH by IIF, and anti Actin was present only in patients with AIH. In Non A-E group, 4 cases had AMA and M2; 3 cases had high titer of SMA and other 4 cases with SS A, SS B or dsDNA etc. Conclusion The detection of anti liver antigens, ANA profile and AMA subtypes are helpful for diagnosis of autoimmune liver diseases and overlap syndromes; some patients should be considered as PBC or AIH in Non A-E hepatitis patients. [

关 键 词：抗肝抗原自身抗体 肝炎 自身免疫性肝炎 原发性胆汁性肝硬化 自身抗体 诊断 

分 类 号：R575[医药卫生—消化系统]