自身免疫性肝炎患者抗可溶性肝抗原抗体检测的价值  

Value of anti-soluble liver antigen antibody detection in patients with autoimmune hepatitis

作　　者：吕晓丹 彭姗姗 王萍[1] 王雷[1] 钟艳丹[1] LV Xiaodan;PENG Shanshan;WANG Ping;WANG Lei;ZHONG Yandan(Department of Hepatology,The Second Hospital of Nanjing,Nanjing 210003,Jiangsu,China)

机构地区：[1]南京市第二医院肝病科,南京210003

出　　处：《临床检验杂志》2024年第11期821-824,共4页Chinese Journal of Clinical Laboratory Science

摘　　要：目的检测自身免疫性肝炎(AIH)患者血清抗可溶性肝抗原(SLA)抗体水平并分析其在肝脏损伤中的价值。方法回顾性分析南京市第二医院2017年1月至2024年4月确诊的33例抗SLA抗体阳性AIH患者及33例年龄、性别匹配的抗SLA抗体阴性AIH病例数据。收集患者的一般及临床资料,检测抗SLA抗体(蛋白质印迹法)、抗核抗体(间接免疫荧光法)等自身免疫肝病抗体、总胆红素(T-Bil)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(GGT)、碱性磷酸酶(ALP)以及免疫球蛋白IgG水平。分析并比较患者的临床特征、实验室参数以及肝组织病理学特点。结果两组患者性别、年龄、自身免疫肝病抗体(如抗核抗体、抗平滑肌抗体等)及肝功能指标(AST、ALT、GGT、ALP)比较,差异均无统计学意义(P>0.05)。而抗SLA抗体阳性患者的T-Bil、IgG水平显著高于阴性组(P值分别为0.017、0.048)。肝组织病理检查发现,抗SLA阳性组有淋巴细胞-浆细胞浸润表现的患者比例显著高于抗SLA阴性组(χ2=4.243,P<0.05),提示更活跃的免疫反应。结论AIH患者血清抗SLA抗体水平检测有助于反映肝脏损伤程度,具备辅助诊断及监测病情的潜能。Objective To detect the levels of anti-soluble liver antigen(anti-SLA)antibodies in the serum of patients with autoimmune hepatitis(AIH)and analyze their value in liver injury.Methods A retrospective analysis was conducted on 33 AIH patients with anti-SLA antibody-positive and 33 age-and sex-matched anti-SLA antibody-negative AIH cases diagnosed at Nanjing Second Hospital from January 2017 to April 2024.The general and clinical data of the patients were collected along with the detection of anti-SLA antibody(by protein immunoblotting),anti-nuclear antibodies(by indirect immunofluorescence)and other autoimmune liver disease-related autoantibodies,the biochemical parameters,e.g.,total bilirubin(T-Bil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),and the level of immunoglobulin IgG.The clinical characteristics,laboratory parameters,and liver histopathological features of the patients were analyzed and compared.Results There were no statistically significant differences were observed in gender,age,autoimmune liver disease-related antibodies(such as antinuclear antibody,anti-smooth muscle antibody,etc.)and liver function parameters(AST,ALT,GGT and ALP),between the two groups of patients(P>0.05).However,in the patients with positive anti-SLA antibodies,the levels of T-Bil and IgG in serum were significantly higher than those of the negative group with both P value less than 0.05(P values of 0.017 and 0.048,respectively).The pathological examination for liver tissue revealed that the proportion of the patients with lymphocyte-plasma cell infiltration in anti-SLA-positive group was significantly higher than that in anti-SLA-negative group(χ2=4.243,P<0.05),suggesting more active immune response.Conclusion The detection of anti-SLA antibodies levels in the serum of AIH patients may reflect the extent of liver injury,and should have the potential for assisting diagnosis and monitoring the disease condition.

关 键 词：自身免疫性肝炎 抗可溶性肝抗原抗体 免疫球蛋白G 肝脏病理 

分 类 号：R446.6[医药卫生—诊断学]