肝病患者自身抗体特征性的研究  

Characteristic study on autoantibodies in patients with liver diseases

作　　者：阎惠平[1] Winfried Stecker 贺立香[1] 张世斌[1] 孔淑玲[1] 于红卫[1] 闵福援[1] 

机构地区：[1]首都医科大学北京佑安医院,北京100054 [2]德国EUROIMMUN实验免疫制品有限公司

出　　处：《中国免疫学杂志》2003年第4期278-281,共4页Chinese Journal of Immunology

摘　　要：目的 :观察抗肝抗原自身抗体在我国不同类型肝病患者中的存在状况 ;探讨自身免疫性肝脏疾病的自身抗体特征。方法 :间接免疫荧光法初筛 14 12例肝功能异常血清 ,从中选择 2 2 8例 :①自身免疫性肝病组 4 2例 :初步诊断为AIH 18例、PBC 2 1例、PSC 3例。②HAV组 2 3例 ;③HBV组 70例 ;④HCV组 33例 ;⑤非甲～非戊型肝炎组 6 0例。结合Westernblot、酶免疫条带技术等分别检测ANA、AMA、SMA、LKM 1、LC 1、SLA LP和AMA M2亚型、dsDNA及ENA类多种抗体。结果 :14 12例中诊断AIH、PBC和PSC者分别为送检标本的 12 7‰ ,14 9‰和 2 1‰。 2 2 8例血清中 2例LKM 1阳性和 2例SLA LP阳性 ;按AIH的分型标准 ,自身免疫性肝病组属于I型AIH者 14例 (78% ) ,II型 2例 (11% ) ,III型 2例 (11% ) ;AIH患者ANA抗体未见特定的荧光类型。PBC患者AMA和M2全部阳性 ;其ANA以核膜型为主 (7 14 )。NonA～E组 4例AMA和M2阳性 ,3例SMA高滴度阳性 ,4例出现SS A、SS B或dsDNA等抗体。结论 :三型自身免疫性肝炎在中国都存在 ,肝抗原自身抗体和ANA及AMA的分型检测有助于自身免疫性肝病的诊断与治疗 ;少数非甲～非戊型肝炎应考虑自身免疫性肝病诊断。Objective:To study several anti liver antigens in Chinese patients with different liver diseases and to discuss the characteristic of autoantibodies in autoimmune liver diseases Methods:From 1 412 patients, detected by IIF initially, 228 patients with abnormal ALT were chosen and divided into 5 groups:① autoimmune diseases group, of 42 cases 18 were primarily diagnosed autoimmune hepatitis (AIH), 21 were primary biliary cirrhosis (PBC), 3 with primary sclerosing cholangitis(PSC) ②HAV group, 23 cases;③HBV group, 70 cases;④HCV group, 33 cases and ⑤ NonA～E group, 60 cases ANA, AMA, SMA and LKM were tested by IIF, then, LKM 1, LC 1, SLA/LP and subtype of AMA (M2) as well as ANA profile were detected by Western blot, EUROASSAY respectively Results:In 1 412 cases, diagnosed AIH, PBC and PSC were 12 7‰, 14 9 ‰ and 2 1‰?2 of 228 were LKM 1 positive and 2 of 228 with SLA/LP Therefore 14/18 AIH (78%) were type I, 2 were type II and 2 were type III of AIH No specific ANA patterns were seen in AIH by IIF in patients with AIH AMA and M2 positive in all PBC and its main ANA pattern was nuclear membrane (7/14) In NonA～E group, 4 had AMA and M2; 3 had high titer of SMA and other 4 with SS A, SS B or dsDNA etc Conclusion:Three types of AIH are present in China; The detection of anti liver antigens, ANA profile and AMA subtypes were helpful for diagnosis of autoimmune liver diseases; some patients should be considered as PBC or AIH in NonA～E hepatitis patients

关 键 词：肝病 自身抗体特征性 研究 自身免疫性肝炎 原发性胆汁性肝硬化 

分 类 号：R575.103[医药卫生—消化系统]