抗gp210抗体抗sp100抗体与原发性胆汁性胆管炎患者临床特征及预后关系的研究  

Study on the relationship between anti-gp210,anti-sp100 antibodies and clinical features and prognosis of patients with primary biliary cholangitis

作　　者：张静怡 冯娟 张虹雨[1] 聂静[1] 虞弘[1] 唐映梅[2] Zhang Jingyi;Feng Juan;Zhang Hongyu;Nie Jing;Yu Hong;Tang Yingmei(Department of Gastroenterology,the First Hospital of Kunming,Kunming 650032,China;Department of Gastroenterology,The Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明市第一人民医院消化内科,昆明650032 [2]昆明医科大学第二附属医院消化内科,昆明650101

出　　处：《中华风湿病学杂志》2023年第8期505-512,共8页Chinese Journal of Rheumatology

基　　金：国家自然科学基金(81660102,81360072);昆明医科大学第二附属医院院内临床研究项目(2020ynlc010,ynlIT2021017)。

摘　　要：目的研究抗gp210抗体、抗sp100抗体与PBC患者临床特征及预后的相关性。方法回顾性纳入了云南省9所医疗中心自2015年1月1日至2021年12月31日就诊的PBC患者992例。收集患者的一般资料、病史、熊去氧胆酸(UDCA)治疗情况、实验室检查及影像学检查资料,并进行电话随访。对比不同临床特征的PBC患者中抗gp210抗体、抗sp100抗体阳性率,并对比抗gp210抗体、抗sp100抗体阳性组与阴性组患者实验室指标水平及预后差异。采用t检验、秩和检验、方差分析进行统计处理。结果汉族患者抗gp210抗体阳性率较少数民族明显增加(21.5%与9.9%,χ^(2)=6.88,P=0.009),抗sp100抗体阳性率2组患者相比差异无统计学意义(10.9%与6.6%,χ^(2)=1.62,P=0.204)。不同性别、年龄患者抗gp210抗体(χ^(2)=0.50,P=0.478;Z=-0.41,P=0.682)、抗sp100抗体阳性率(χ^(2)=0.01,P=0.951;Z=-0.60,P=0.549)均差异无统计学意义。抗gp210抗体在抗线粒体抗体(AMA)M2抗体阳性与阴性患者(19.1%与24.7%,χ^(2)=3.45,P=0.063)、合并SS较未合并SS(21.3%与20.4%,χ^(2)=0.05,P=0.828)、合并病毒性肝炎与未合并病毒性肝炎(19.6%与20.5%,χ^(2)=0.02,P=0.877)的PBC患者中阳性率差异无统计学意义;在诊断不明进行肝穿刺活检确诊PBC的患者(25.6%与18.4%,χ^(2)=6.52,P=0.011)、合并自身免疫性肝炎(AIH)(26.6%与18.9%,χ^(2)=5.82,P=0.016)、肝硬化(23.3%与11.3%,χ^(2)=16.00,P<0.001)、出现肝硬化失代偿症状(23.9%与18.2%,χ^(2)=4.66,P=0.031)、黄疸(29.7%与17.1%,χ^(2)=18.59,P<0.001)、高脂血症(24.9%与18.1%,χ^(2)=6.30,P=0.012)的患者中,抗gp210抗体阳性率均显著增加。抗sp100抗体在AMA M2抗体阴性(20.9%与7.2%,χ^(2)=36.54,P<0.001)、诊断不明进行肝穿刺活检确诊PBC的患者(17.9%与7.5%,χ^(2)=23.40,P<0.001)中阳性率明显升高,而在合并AIH(11.1%与10.3%,χ^(2)=0.09,P=0.769)、SS(15.7%与10.0%,χ^(2)=2.87,P=0.090)、病毒性肝炎(4.3%与10.8%,χ^(2)=1.94,P=0.164)、肝硬化(10.5%与10.5%,χ^(Objective To study the correlation between anti-gp210 antibody,anti-sp100 antibody with clinical features and prognosis of patients with PBC.Methods A total of 992 patients with PBC from 9 medical centers in Yunnan Province from January 1,2015 to December 31,2021 were included retrospectively.The demographic data,medical history,UDCA treatment,laboratory and imaging data were collected,and telephone follow-up was conducted.The positive rates of anti-gp210 antibody and anti-sp100 antibody in PBC patients with different clinical characteristics were compared,and the differences of laboratory parameters and prognosis between the anti-gp210 and anti-sp100 antibodies positive and negative groups were compared.T test,rank sum test,variance analysis were used for statistical analysis.Results The positive rate of anti-gp210 antibody in Han patients was significantly higher than that in minority patients(21.5%vs 9.9%,χ^(2)=6.88,P=0.009),but there was no significant difference in the positive rate of anti-sp100 antibody between the two groups(10.9%vs 6.6%,χ^(2)=1.62,P=0.204).There were no significant differences in the positive rates of anti-gp210 antibody and anti-sp100 antibody among different genders(χ^(2)=0.50,P=0.478)(Z=-0.41,P=0.682)and ages(χ^(2)=0.01,P=0.951)(Z=-0.60,P=0.549).There was no significant difference in the positive rate of anti-gp210 antibody between AMA M2 antibody positive and negative patients(χ^(2)=3.45,P=0.063),PBC patients with Sjögren′s syndrome compared with those without Sjögren′s syndrome(21.3%vs 20.4%,χ^(2)=0.05,P=0.828),and PBC patients with viral hepatitis compared with those without viral hepatitis(19.6%vs 20.5%,χ^(2)=0.02,P=0.877).The positive rate of anti-gp210 antibody was significantly increased in patients with PBC confirmed by liver biopsy with unknown diagnosis(25.6%vs 18.4%,χ^(2)=6.52,P=0.011),patients with AIH(26.6%vs 18.9%,χ^(2)=5.82,P=0.016),cirrhosis(23.3%vs 11.3%,χ^(2)=16.00,P<0.001),decompensation of cirrhosis(23.9%vs 18.2%,χ^(2)=4.66,P=0.031),jaundice(29.7%v

关 键 词：胆管炎 诊断 预后 抗gp210抗体 抗sp100抗体 

分 类 号：R575.7[医药卫生—消化系统]