原发性胆汁性胆管炎患者血清自身抗体和临床特征分析  

Prevalence of serum autoantibodies and clinic features in patients with primary biliary cholangitis

作　　者：李文渊[1] 叶超[2] 李磊[1] 方芳[2] 陈思 王陆军 张开光 Li Wenyuan;Ye Chao;Li Lei(Department of Infectious Diseases and Department of Gastroenterology,First Affiliated Hospital,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,Anhui Province,China)

机构地区：[1]中国科学技术大学附属第一医院感染病科,合肥市230000 [2]中国科学技术大学附属第一医院消化科,合肥市230000

出　　处：《实用肝脏病杂志》2020年第4期516-519,共4页Journal of Practical Hepatology

基　　金：安徽省自然科学青年基金资助项目(编号:1908085QH331);中国科学技术大学新医学联合基金资助项目(编号:WK9110000023)。

摘　　要：目的原发性胆汁性胆管炎(PBC)是我国常见的一种自身免疫性肝病,本研究对PBC患者血清自身抗体阳性情况和临床特征进行了分析,以期为其临床诊治提供参考。方法回顾性分析我院住院诊治的230例PBC患者的临床资料,采用欧盟试剂检测血清抗线粒体抗体(AMA和AMA-M2)、抗核糖核蛋白(RNP)抗体、抗SSA60、抗SSA52、抗SSB、抗着丝点蛋白B(CENP-B)、抗双链DNA(dsDNA)、抗组蛋白、抗Sp100、抗gp210和抗核小体抗体(ANua)等。分析合并其他自身免疫性疾病,包括干燥综合征(SS)和系统性红斑狼疮(SLE)等。结果在230例PBC患者中,AMA-M2阳性167例(72.6%),抗gp210阳性101例(43.9%),抗Sp100阳性39例(17.0%);在所有PBC患者中,有178例(77.4%)ANA阳性;血清抗SSA52和抗CENP-B阳性率分别为37.4%和20.0%;在所有PBC患者中,合并SS者54例(23.5%),合并SLE者21例(9.1%);与156例代偿期肝硬化比,74例失代偿期患者血清抗gp210和抗SSA52阳性率显著升高,分别为63.5%对34.6%(P<0.05)和(44.6%对29.5%,P<0.05),差异有统计学意义。结论本研究发现血清AMA-M2、抗gp210和抗Sp100等仍然是诊断PBC的特征性指标。PBC患者血清抗SSA52和抗CENP-B阳性率也较高,可以作为补充诊断的潜在指标。本研究还发现血清抗gp210和抗SSA52阳性可能提示PBC病情较严重。SS和SLE作为PBC患者的常见合并症,其具体的发病机制和与疾病进程的关系,仍值得我们进一步的深入研究。Objective Primary biliary cholangitis(PBC)is a common autoimmune disease all over the world.The aim of this study was to investigate prevalence of serum autoantibodies and clinic features in patients with PBC.Methods A retrospective analysis was performed on 230 patients with PBC.All clinic characteristic and serum autoantibodies including Anti-Sm,RNP,SSA60,SSA52,SSB,CENP-B,dsDNA,antihistone antibodies,AMA-M2,Sp100,gp210 and ANua,were assayed.Other autoimmune diseases,such as Sjogren syndrome(SS),systemic lupus erythematosus(SLE)were recorded.Results Out of the 230 patients with PBC,the prevalence of serum AMA-M2,anti-gp210 and anti-Sp100 were positive in 167(72.6%),101(43.9%),and 39(17%)patients;serum ANA was positive in 178(77.4%)patients;serum anti-SSA and anti-CENP-B were positive in 37.4%and 20.0%in spite of positive serum autoantibodies above;SS and SLE were found in 54 and 21 patients(23.5%and 9.1%);anti-gp210 and anti-SSA52 had a higher positive rates in 74 patients with decompensated liver functions(63.5%vs.34.6%,P<0.05 and 44.6%vs.29.5%,respectively,P<0.05)as compared to those in 156 patients with compensated liver functions.Conclusion Serum AMA-M2,anti-GP210 and anti-Sp100 are still key diagnostic index,and serum anti-SSA52 and anti-CENP-B have relatively high positive rate in patients with PBC.We also found that the patients with positive anti-gp210 and anti-SSA52 might have a severe liver disease.

关 键 词：原发性胆汁性胆管炎 自身抗体 诊断 

分 类 号：R575.7[医药卫生—消化系统]