老年人自身免疫性肝病自身抗体谱的检测及临床特征  

Detection and Clinical Characteristics of Autoantibody Spectrum in Elderly Patients With Autoimmune Liver Disease

作　　者：洪海龙 占启川 HONG Hailong;ZHAN Qichuan(Department of Infection,Quangang General Hospital,the First Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362801,China;Department of Laboratory,Quangang General Hospital,the First Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362801,China)

机构地区：[1]福建医科大学附属第一医院泉港总医院感染科,福建泉州362801 [2]福建医科大学附属第一医院泉港总医院检验科,福建泉州362801

出　　处：《中国卫生标准管理》2024年第1期133-136,共4页China Health Standard Management

摘　　要：目的分析采用自身抗体谱检测法进行老年人自身免疫性肝病(autoimmune liver disease,AILD)检测的价值和临床特征。方法选取福建医科大学附属第一医院泉港总医院2020年7月—2023年6月90例老年AILD患者,根据病情分为A组、B组、C组,各30例。A组为自身免疫性肝炎(autoimmune hepatitis,AIH),B组为原发性胆汁性肝病(primary biliary liver disease,PBC),C组为原发性硬化胆管病(primary sclerosing cholangitis,PSC)。3组均进行自身抗体谱检测。比较3组抗线粒体抗体(anti-mitochondrial antibody,AMA)、抗核抗体(antinuclear antibody,ANA)检测结果和抗可溶性肝抗原/肝胰抗原(soluble liver antigen/liver pancreas,SLA/LP)、抗肝肾微粒体(liver-kidney microsomal,LKM)抗体Ⅰ型、抗平滑肌抗体(anti-smooth muscle antibody,SMA)滴度检测结果以及并发症发生率。结果B组AMA阳性率(90.00%)高于A组(0)、C组(0),差异有统计学意义(P<0.05);A组ANA阳性率(93.33%)高于B组(66.67%)、C组(63.33%),差异有统计学意义(P<0.05);B组与C组ANA阳性率、A组与C组AMA阳性率比较,差异无统计学意义(P>0.05)。A组(40.00%)SLA/LP阳性率高于B组(0)、C组(0),差异有统计学意义(P<0.05);A组抗LKM抗体Ⅰ型阳性率(26.67%)高于B组(0)、C组(0),差异有统计学意义(P<0.05);A组(40.00%)SMA滴度(≥1∶320)阳性率高于B组(0)、C组(0),差异有统计学意义(P<0.05)。肝硬化发生率B组(60.00%)>A组(20.00%)>C组(0),差异有统计学意义(P<0.05);A组(3.33%)胆囊结石伴慢性胆囊发生率低于C组(46.67%)、B组(23.33%),差异有统计学意义(P<0.05);3组高血压、消化性溃疡、贫血、慢性乙型肝炎、干燥综合征、系统性红斑狼疮、类风湿关节炎发生率比较,差异无统计学意义(P>0.05)。结论自身抗体谱检测法对于老年AILD诊断具有积极意义,不同类型AILD在抗原抗体检测阳性率和并发症方面存在一定差异。Objective To analyze the value and clinical characteristics of the detection of autoimmune liver disease(AILD)by autoantibody spectrum in the elderly.Methods A total of 90 patients with AILD were selected in Quangang General Hospital,the First Affiliated Hospital of Fujian Medical University from July 2020 to June 2003.According to the condition,they were divided into group A and group B and group C,30 cases each.Group A was autoimmune hepatitis,group B was primary biliary liver disease,group C was primary sclerosing cholangiopathy.All three groups were tested for autoantibody profiles.The results of anti-mitochondrial antibody(AMA),antinuclear antibody(ANA),and soluble liver antigen/liver pancreas(SLA/LP),anti-liver-kidney microsomal(LKM)antibody typeⅠ,anti-smooth muscle antibody(SMA)titer detection and incidence of comorbidities were compared.Results The positive rate of AMA in group B(90.00%)was higher than that in group A(0)and group C(0),the differences were statistically significant(P<0.05);the positive rate of ANA in group A(93.33%)was higher than that in group B(66.67%)and group C(63.33%),and the differences were statistically significant(P<0.05);there were no significant differences in the positive rate of ANA between group B and group C,and the positive rate of AMA between group A and group C(P>0.05).The positive rate of SLA/LP in group A(40.00%)was higher than that in group B(0)and group C(0),and the differences were statistically significant(P<0.05);the positive rate of anti-LKM antibody typeⅠin group A(26.67%)was higher than that in group B(0)and group C(0),the differences were statistically significant(P<0.05);the positive rate of SMA titer(≥1:320)in group A(40.00%)was higher than that in group B(0)and group C(0),and the differences were statistically significant(P<0.05).Incidence of liver cirrhosis group B(60.00%)>group A(20.00%)>group C(0),the differences were statistically significant(P<0.05);the incidence of gallstones with chronic gallbladder in group A(3.33%)was lower than that in group

关 键 词：自身抗体谱检测 自身免疫性肝病 老年患者 抗线粒体抗体 抗核抗体 并发症 

分 类 号：R575[医药卫生—消化系统]