摘要
目的研究自身免疫性肝病(AILD)患者初入院及药物治疗过程中血清自身抗体的动态变化,探讨其临床应用及意义。方法应用间接免疫荧光法检测64例自身免疫性肝炎(AIH)患者和57例原发性胆汁性肝硬化(PBC)患者初入院及接受临床治疗不同时间(1、3、12、24个月)的血清中抗核抗体(ANA),同时用免疫印迹法对血清中的肝病相关抗体谱(AMA-M2抗体、Sp100抗体、gp210抗体、LKM-1抗体、LC-1抗体、SLA抗体)进行检测,结合肝脏酶学检测结果进行相关性分析。结果治疗前AIH与PBC患者血清中ANA的检出率分别是57.8%和61.4%,滴度集中于1∶320和1∶640,治疗中AILD患者血清中ANA阳性率与滴度不随病情缓解而明显改变(P>0.05);肝病抗体谱检测,PBC患者血清中只有AMA-M2抗体、Sp100抗体、gp210抗体检出,检出率依次是73.7%、17.5%、26.3%,AIH患者6项抗体均有不同程度检出,但以LKM-1、LC-1、SLA特异性检出为主;治疗1、3、12、24个月AILD患者肝功能指标逐渐恢复(P<0.05),自身抗体谱检出情况差异无统计学意义(P>0.05)。结论自身抗体检测对于AILD的诊断、鉴别诊断具有非常重要的作用,但不随病情缓解而改变,不能作为临床疗效观察的指标。
Objective To investigate the dynamic changes of serum autoimmune antibodies before and during treatment in auto-immune liver disease（AILD）and to study their clinical application and the practical significance.Methods The indirect immunoin-fluorescence was used to measure serum anti-nuclear antibody（ANA）on admission and at different clinical treatment time （1,3,12, 24 months）in 64 cases of autoimmune hepatitis（AIH）and 57 cases of primary biliary cirrhosis（PBC）.At the same time the immu-noblot analysis was adopted to detect the liver disease related antibodies （anti-AMA-M2 antibody,anti-Sp100 antibody,anti-gp210 antibody,anti-LKM-1 antibody,anti-LC-1 antibody and anti-SLA antibody）.The correlation analysis was performed by combining with the detection results of the liver enzymology.Results The detection rate of serum ANA before treatment was 57.8% in the AIH patients and 61.4% in the PBC patients respectively,and the titer was mostly distributed in 1∶320 and 1∶640.During treat-ment,the positive rate and titer of serum ANA in the AILD patients had no obvious change with the disease condition relief（P＆gt;0.05）;in the liver disease antibodies detection,only anti-AMA-M2 antibody,anti-Sp100 antibody and anti-gp210 antibody were de-tected in the PBC patients,and the detection rates were in turn 73.7%,17.5% and 26.3% respectively;6 items of antibody were detected to different extent in the AIH patients,but which was dominated by the specific detection of anti-LKM-1 antibody,anti-LC-1 antibody and anti-SLA antibody;the liver function indexes in the ALID patients were gradually recovered after 1,3,12,24 months treatment（P〈0.05）,there was no significant change in the autoimmune antibodies detection（P＆gt;0.05）.Conclusion The autoimmune antibodies detection plays a very important role in diagnosis and differential diagnosis of AILD,but which has no change with the disease condition relief,thus can not be used as the index of the clinical curative effect observation.
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第16期2032-2034,共3页
Chongqing medicine
基金
常州市社会发展科技计划项目(CJ20122015)
关键词
肝炎
自身免疫性
肝硬化
胆汁性
自身抗体
hepatitis,autoimmune
liver-cirrhosis,biliary
autoimmune-antibodies
