摘要
目的检测慢性乙型肝炎儿童自身抗体的阳性率,探讨其自身抗体存在的临床意义。方法采用间接免疫荧光法检测84例慢性乙型肝炎儿童、69例慢性乙型肝炎成人和15例正常儿童抗核抗体(ANA)的阳性率、滴度、核型和抗平滑肌抗体(SMA)、抗线粒体抗体(AMA)、抗肝肾微粒体抗体(LKM)、抗胃壁细胞抗体(APCA)的阳性率。同时检测患者的ALT、AST,对慢性乙型肝炎儿童取肝活检组织作病理组织学检查。结果 (1)慢性乙型肝炎儿童组总自身抗体阳性率为19.0%,较成人慢性乙型肝炎患者组为低(P<0.05)。(2)慢性乙型肝炎儿童组检出的ANA以低滴度(1:100)为主,有3例滴度为1:320;ANA核型全部为均质型;仅有1例SMA阳性,未见其他自身抗体阳性。(3)慢性乙型肝炎儿童自身抗体阳性组的ALT、AST水平均高于自身抗体阴性组(P<0.05)。(4)慢性乙型肝炎儿童自身抗体阳性组肝脏病理G>2者占43.8%,较自身抗体阴性组G>2者(16.2%)比例明显增高,差异有统计学意义(P<0.05)。结论慢性乙型肝炎儿童中也有一定比例存在自身抗体,但较成人慢性乙型肝炎患者为低。自身抗体的产生与肝损伤程度有一定相关性,检测慢性乙型肝炎儿童自身抗体对选择抗病毒治疗方案有一定的指导意义。
Objective To explore the significance of autoantibodies in pediatric patients with chronic hepatitis B.Methods Serous antinuclear antibody(ANA),anti-smooth muscle antibody(SMA),anti-mitochondrial antibody(AMA),anti-liver kidney microsomal antibody(LKM) and anti-gastric parietal cell antibody(APCA) of 153 patients with chronic hepatitis B(including 84 children and 69 adults) were detected by indirect immunofluorescence,and that of 15 health children as control.Meanwhile,aspartate aminotransferase(ALT) and aspartate aminotransferase(AST) were also examined.All the pediatric patients with chronic hepatitis B were underwent liver biopsies.Results The positive rate of serous autoantibodies was significantly different between the pediatric patients(19%) and the adult patients(33.3%).The serous levels of ANA in most of the pediatric chronic hepatitis B patients were low(the titers of ANA were always bellow 1:100),only three of them had higher levels(the titers of ANA were 1:320),and all of the ANA were homogeneous type.Except SMA positive expression in a pediatric patient,the rest autoantibodies were all negative.The levels of ALT and AST in autoantibody positive pediatric patients were significantly higher than those negative(P<0.05).The percent of the score of inflammation above G2 in all of the autoantibody positive pediatric patients was 43.8%,and it was significantly higher compared with that in the autoantibody negative pediatric patients(the percent of G>2 was 16.2%).Conclusions Autoantibody could be expressed in part of pediatric chronic hepatitis B patients,but the rate of positive expression is lower than that in adults.Autoantibody emerging seems to have some correlation with the degree of liver injury.Autoantibody detection may have some significances in antiviral therapy schedule designing.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第15期4336-4339,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
儿童
自身抗体
肝炎
乙型
慢性
Child
Autoantibodies
Hepatitis B,chronic
