自身免疫性肝病抗体分布特征调查分析  

Investigation and analysis of antibody distribution in autoimmune liver disease

作　　者：崔京京[1] 杨莹 胡月[1] 刘欣[1] 刘士超[1] 郭亚平[1] 张彦[1] CUI Jing-jing;YANG Ying;HUYue;LIU Xin;LIU Shi-chao;GUO Ya-ping;ZHANG Yan(Baoding No.1 Central Hospital,071000 Baoding,Hebei China)

机构地区：[1]保定市第一中心医院,河北保定071000

出　　处：《临床消化病杂志》2021年第2期121-124,共4页Chinese Journal of Clinical Gastroenterology

基　　金：河北省卫建委重点研究室支撑项目(冀中医药[2014]28-14)。

摘　　要：[目的]分析抗平滑肌抗体(ASMA)、抗线粒体抗体(AMA)、抗gp210抗体、抗sp100抗体等自身免疫性肝病抗体阳性人群分布特征,揭示自身免疫性肝病抗体检测的重要性。[方法]收集整理我院近5年就诊人群中自身免疫性肝病抗体阳性者病历资料并进行回顾性分析、对比分析等,计数资料组间率的比较采用χ2检验,P<0.05为差异有统计学意义。[结果]就诊人群自身免疫性肝病抗体ASMA和AMA/AMA-M2阳性检出率较高,为17.76%(535/3013)和10.89%(328/3013)。近5年自身免疫性肝病抗体阳性检出率呈逐年上升趋势,且男性所占比例愈来愈高。488例ASMA阳性者明确诊断为自身免疫性肝炎175例,确诊率为35.86%;AMA/AMA-M2、抗sp100抗体、抗gp210抗体三者联合检测可提高原发性胆汁性胆管炎的确诊率;自身免疫性肝病抗体联合检测有助于重叠综合征确诊。自身免疫性肝病抗体阳性者皮肤巩膜黄染、腹部不适、食欲不振乏力等检出率分别为8.70%(106/1219)、16.74%(204/1219)、6.32%(77/1219),明显高于阴性者。[结论]应重视自身免疫性肝病抗体的检测尤其是男性患者,该人群极易被忽视,导致漏诊误诊;对出现腹部不适、食欲不振、乏力等症状不典型者及早检测,及早干预。[Objective]To explore the distribution characteristics of autoimmune liver disease patients with positive anti-smooth muscle antibody(ASMA),anti mitochondrial antibody(AMA),anti-gp210 antibody,anti-sp100 antibody,and reveal the importance of autoimmune liver disease antibody early detection.[Methods]The data of the patients with positive autoimmune liver disease antibody in our hospital in recent 5 years were collected and analyzed retrospectively.The rate between groups was compared byχ2 test.[Results](1)The positive rates of ASMA and AMA/AMA-M2 were 17.76%(535/3013)and 10.89%(328/3013)respectively.(2)With the increase of age,the positive rate of autoimmune liver disease showed a downward trend,and the proportion of male increased.(3)The totals of 488 cases of ASMA positive were definitely diagnosed as autoimmune hepatitis,the diagnosis rate was 35.86%;combined detection of antibodies was helpful to the diagnosis of overlap syndrome.(4)The prevalence of skin and sclera yellow staining,abdominal discomfort,anorexia and fatigue were 8.70%(106/1219),16.74%(204/1219)and 6.32%(77/1219)respectively,which were significantly higher than those in the negative group.[Conclusion]Attention should be paid to the detection of antibodies against autoimmune liver disease,especially in male patients,who were easily ignored and misdiagnosed.Patients with atypical symptoms such as abdominal discomfort,loss of appetite and fatigue should be detected and intervened as soon as possible.

关 键 词：肝疾病 自身免疫性肝病 抗体 

分 类 号：R575[医药卫生—消化系统]