自身免疫性肝炎临床特点分析及血清相关抗体检测水平分析  

Analysis of clinical features of autoimmune hepatitis and detection of serum related antibodies

作　　者：李应 庞源源 陈虹余 LI Ying;PANG Yuanyuan;CHEN Hongyu(Department of Gastroenterology,Gaoping District People's Hospital,Nanchong,Sichuan,China,637100)

机构地区：[1]南充市高坪区人民医院消化内科,四川南充637100

出　　处：《分子诊断与治疗杂志》2022年第2期346-349,353,共5页Journal of Molecular Diagnostics and Therapy

基　　金：南充市科技计划项目(21YFZJ0113)。

摘　　要：目的探究自身免疫性肝炎(AIH)临床特点及血清相关抗体检测水平。方法选取2017年8月至2020年5月南充市高坪区人民医院AIH患者106例设为研究组、胆汁淤积性肝炎患者106例设为对照组,另选取同期健康体检者106例设为健康组。统计研究组基本情况、三组人口学特征,并抽取三组血液样本测定肝功能指标、免疫指标、相关抗体水平,并分析AIH发病影响因素。结果 AIH患者主要为女性,占比86.79%,饮食不规律占比47.17%,多伴有腹胀、腹痛、食欲减退、乏力、关节肿痛、肝大、脾大,患者肝功能指标ALT、ALP、GGT、AST水平升高,血清免疫球蛋白G(IgG)、IgM明显升高,差异有统计学意义(P<0.05);研究组抗肝细胞溶质抗原1型(LC-1)、抗可溶性肝抗原(SLA)、抗肝肾微粒体抗体1型(LKM-1)、抗平滑肌抗体(SMA)、抗核抗体(ANA)、抗着丝点抗体(ACA)阳性率>对照组>健康组,对照组抗线粒体抗体(AMA)阳性率>研究组>健康组,对照组ACA、抗核膜糖蛋白抗体(gp210)、SMA、ANA阳性率>健康组,差异均有统计学意义(P<0.05);LC-1、SLA、LKM-1、AMA、SMA、ANA、ACA、IgG、IgM均为AIH发病的重要影响因素(P<0.05)。结论 AIH患者以女性为主,临床表现复杂多样,患者肝功能异常,血清IgG、IgM及相关抗体阳性表达率明显升高,肝组织学特征、免疫指标及相关抗体是诊断本病的重要依据。Objective To explore the clinical characteristics and serum related antibody detection levels of autoimmune hepatitis(AIH). Methods From August 2017 to May 2020,106 patients with AIH in Gaoping District People’s Hospital of Nanchong City were selected as the research group,106 patients with cholestatic hepatitis were selected as the control group,and 106 healthy people who underwent physical examination during the same period were selected as healthy Group. The basic situation of the research group and the demographic characteristics of the three groups were counted,and three groups of blood samples were drawn to measure liver function indexes,immune indexes,and related antibody levels,and to analyze the influencing factors of AIH incidence. Results AIH patients were mainly women,accounting for 86.79%,and irregular diet accounted for 47.17%,which were mostly accompanied by abdominal distension,abdominal pain,loss of appetite,fatigue,joint swelling and pain,hepatomegaly,and spleen. The levels of GGT and AST increased,and the serum immunoglobulin G(IgG)and IgM increased significantly,and the difference was statistically significant(P<0.05). Antigen(SLA),anti-liver-kidney microsomal antibody type 1(LKM-1),anti-smooth muscle antibody(SMA),anti-nuclear antibody(ANA),and anti-centromere antibody(ACA)positive rate > control group and healthy group,The positive rate of anti-mitochondrial antibody(AMA)in the control group > the study group > the healthy group,the positive rate of ACA,anti-nuclear membrane glycoprotein antibody(gp210),SMA,ANA in the control group > the healthy group(P<0.05);LC-1,SLA,LKM-1,AMA,SMA,ANA,ACA,IgG,IgM were all important influencing factors of AIH(P<0.05). Conclusion AIH patients are mainly female,with complex and diverse clinical manifestations,abnormal liver function,and significantly increased serum IgG,IgM and related antibodies.positive rate > control group and healthy group,The positive rate of anti-mitochondrial antibody(AMA)in the control group > the study group > the healthy group,the

关 键 词：自身免疫性肝炎 临床特点 肝功能 抗体 

分 类 号：R575[医药卫生—消化系统] R446.6[医药卫生—内科学]