自身免疫性肝病患者血清ANCA、IgG、TNF-α水平及其临床意义  

Levels and clinical significance of serum ANCA,IgG and TNF-αin patients with autoimmune liver disease

作　　者：段金霞[1] 徐曼[1] 陶林静 翟素平[1] 杜伟鹏[1] 席小红[1] Duan Jinxia;Xu Man;Tao Linjing;Zhai Suping;Du Weipeng;Xi Xiaohong(Department of Clinical Laboratory,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院检验科,473000

出　　处：《中国实用医刊》2021年第15期33-36,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析自身免疫性肝病患者血清抗中性粒细胞胞质抗体(ANCA)、免疫球蛋白G(IgG)、肿瘤坏死因子-α(TNF-α)水平变化及其临床意义。方法抽取2018年1月至2020年10月南阳市中心医院收治的自身免疫性肝病患者146例作为患病组,其中原发性胆汁性肝硬化(PBC)98例,自身免疫性肝炎(AIH)48例;并以1∶1配比选取同期健康体检者146例作为健康对照组。检测两组研究对象的ANCA、IgG及TNF-α水平,比较两组血清学指标和患病组不同疾病类型、不同病情程度患者的血清学指标;比较患病组不同病情程度患者的肝功能,包括丙氨酸氨基转氨酶(ALT)、天门冬氨酸氨基转氨酶(AST)、碱性磷酸酶(ALP),分析血清ANCA、IgG、TNF-α水平和病情程度、肝功能的相关性。结果患病组血清ANCA、IgG、TNF-α水平高于健康对照组,差异有统计学意义(P<0.05);PBC患者血清ANCA、IgG、TNF-α水平高于AIH患者(P<0.05);重度患者血清ANCA、IgG、TNF-α水平高于轻、中度患者(P<0.05);重度患者ALT、AST、ALP水平高于轻、中度患者(P<0.05)。Pearson分析结果显示,ANCA(r=0.619)、IgG(r=0.705)、TNF-α(r=0.643)与自身免疫性肝病患者病情程度呈正相关(P<0.05),ANCA(r=-0.437)、IgG(r=-0.398)、TNF-α(r=-0.416)与肝功能呈负相关(P<0.05)。结论 ANCA、IgG、TNF-α在自身免疫性肝病患者中高表达,与病情严重程度呈正相关,与肝功能呈负相关,临床可据此评估患者病情和肝功能情况,制定最佳治疗方案,改善患者预后。Objective To analyze the levels and clinical significance of serum anti-neutrophil cytoplasmic antibody(ANCA),immunoglobulin G(IgG),and tumor necrosis factor-α(TNF-α)in patients with autoimmune liver disease.Methods A total of 146 patients with autoimmune liver disease treated in Nanyang Central Hospital from January 2018 to October 2020 were selected as the disease group,including 98 cases of primary biliary cirrhosis(PBC)and 48 cases of autoimmune hepatitis(AIH).Another 146 healthy patients during the same period were selected as the healthy control group,according to ratio of 1∶1 with the diseas group.The levels of ANCA,IgG and TNF-αwere detected.The serological indexes of the two groups were compared,and the serological indexes of patients with different disease types and degrees were compared.The liver function,assessed by alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP),of the patients with different degrees of disease were compared.The correlations of levels of serum ANCA,IgG and TNF-αwith severity of disease and liver function were analyzed.Results The levels of serum ANCA,IgG and TNF-αof the disease group were higher than those of the healthy control group(P<0.05).The serum ANCA,IgG,and TNF-αlevels of PBC patients were significantly higher than those of AIH patients(P<0.05).The levels of serum ANCA,IgG and TNF-αin severe patients were higher than those in mild patients and moderate patients(P<0.05).The levels of ALT,AST and ALP in severe patients were higher than those in mild patients and moderate patients(P<0.05).Pearson analysis results showed that ANCA(r=0.619),IgG(r=0.705),TNF-α(r=0.643)were positively correlated with autoimmune liver disease patients(P<0.05);ANCA(r=-0.437),IgG(r=-0.398),TNF-α(r=-0.416)were negatively correlated with liver function(P<0.05).Conclusions ANCA,IgG,and TNF-αare highly expressed in patients with autoimmune liver diseases,which are positively correlated with the severity of the disease,and negatively correlated with the

关 键 词：自身免疫性肝病 抗中性粒细胞胞质抗体 免疫球蛋白G 肿瘤坏死因子-α 肝功能 相关性 

分 类 号：R575[医药卫生—消化系统]