3种荧光核型的疾病谱分析及临床相关性研究  

An Analysis of Disease Spectrum and Clinical Correlationof Three Fluorescent Karyotypes

作　　者：石佳[1] 罗开宏 陈丽[1] 王雪安 胡静[1] 杨滨[1] SHI Jia;LUO Kaihong;CHEN Li;WANG Xuean;HU Jing;YANG Bin(West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《标记免疫分析与临床》2022年第8期1339-1343,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨线粒体荧光核型、着丝点荧光核型、着丝点线粒体荧光核型的疾病谱及这3种荧光核型在自身免疫性肝病(autoimmune liver disease,AILD)患者中的临床价值。方法回顾性分析四川大学华西医院2008年1月1日至2020年1月1日期间,使用间接免疫荧光法检测血清抗核抗体谱(antinuclearantibody,ANA)为上述3种荧光核型的患者获得的相关临床资料和实验室常规生化检测数据。采用SPSS 26.0统计学软件对上述3种荧光核型患者资料、实验数据进行对比分析。结果在线粒体荧光核型中,原发性胆汁性胆管炎(primary biliary cholangitis,PBC)占39.8%、慢性肝炎占11.2%、肝硬化占8.4%;着丝点荧光核型中结缔组织疾病占14.7%、干燥综合征占7.5%、类风湿性关节炎占6.1%;着丝点线粒体荧光核型中原发性胆汁性胆管炎(PBC)占47.7%、自身免疫性肝炎占12.2%、肝硬化占10.0%。3种荧光核型中自身免疫性肝病(AILD)患者生化指标差异有统计学意义的是间接胆红素(IBIL,P<0.05)、白蛋白(ALB,P<0.05)、球蛋白(GLB,P<0.05)、总蛋白(TP,P<0.05)。线粒体荧光核型组TP与抗体滴度正相关,相关系数为(r=0.196,P=0.015);着丝点荧光核型组A/G与抗体滴度负相关,相关系数为(r=-0.180,P=0.041),且有显著的关联性。结论线粒体荧光核型多见于原发性胆汁性胆管炎(PBC),是其较特异的荧光核型。着丝点荧光核型可作为自身免疫性疾病筛选指标。3种荧光核型的自身免疫性肝病患者中着丝点荧光核型患者肝功能损害最严重,线粒体荧光核型患者的肝功能损害最轻;线粒体荧光核型患者免疫功能较其他两组更亢进,其抗体滴度水平对自身免疫性肝病患者的肝脏合成功能具有一定的评估功能。Objective To explore the disease spectrum of mitochondrial fluorescent karyotype, centromere fluorescent karyotype, centromere mitochondrial fluorescent karyotype and the clinical value of these three fluorescent karyotypes in patients with autoimmune liver disease(AILD).Methods The clinical data and related biochemical test data of patients whose ANA was detected by indirect immunofluorescence method as the above three fluorescent karyotypes were collected from January, 1, 2008 to January, 1, 2020 in West China Hospital of Sichuan University. Chi-square and t test were used to analyze patients’ data and experimental data of the above three fluorescent karyotypes.Results Among the mitochondrial fluorescent karyotypes, primary biliary cholangitis(PBC) accounted for 39.8%, chronic hepatitis accounted for 11.2%, and liver cirrhosis accounted for 8.4%;In the centromere fluorescent karyotype, connective tissue disease accounted for 14.7%, Sjogren’s syndrome accounted for 7.47%, and rheumatoid arthritis accounted for 6.08%;Among the centromere mitochondrial fluorescence karyotypes, primary biliary cholangitis(PBC) accounted for 47.7%, autoimmune hepatitis accounted for 12.2%, and liver cirrhosis accounted for 10.0%. The routine biochemical indexes of patients with autoimmune liver disease(AILD) showed statistically significant differences, including indirect bilirubin(IBIL, P<0.05), albumin(ALB,P<0.05), globulin(GLB), P<0.05), total protein(TP, P<0.05) of the three fluorescent karyotypes. We identified that TP was positively correlated with antibody titer, while A/G was negatively correlated with antibody titer.Conclusion The mitochondrial fluorescent karyotype is more common in primary biliary cholangitis(PBC), which is a more specific fluorescent karyotype. Centromere fluorescent karyotype can be used as a screening index for autoimmune diseases. Among autoimmune liver disease patients with the three fluorescent karyotypes, patients with the centromere fluorescent karyotype have the most severe liver function dam

关 键 词：线粒体荧光核型 着丝点型荧光核型 着丝点线粒体荧光核型 间接免疫荧光 自身免疫性肝病 

分 类 号：R593[医药卫生—内科学]