摘要
目的：分析PBC患者抗线粒体抗体（AMA）Ⅱ型IgM（M2-IgM）与抗着丝点抗体IgG（ACA-IgG）的关系，探讨M2-IgM和ACA-IgG对PBC早期诊断的临床意义。方法选择36例AMA-IgG和M2-IgG均阴性的PBC患者为研究对象，采用Fisher确切概率法，比较 ACA-IgG阳性组和阴性组M2-IgM阳性检出率，比较M2-IgM阳性组和阴性组病程、病理学及M2-IgG的阳转率。结果 ACA-IgG阳性组检出M2-IgM阳性9例（64%）、阴性5例（36%），ACA-IgG阴性组检出M2-IgM阳性3例（14%）、阴性19例（86%），ACA-IgG阳性组M2-IgM阳性检出率明显高于ACA-IgG阴性组（P=0.003）；M2-IgM阳性组M2-IgG阳转8例（67%）、未阳转4例（33%），M2-IgM阴性组M2-IgG阳转2例（8%）、未阳转22例（92%），M2-IgM阳性组M2-IgG阳转率明显高于M2-IgM阴性组（P=0.001）；M2-IgM阳性组病程和病理学符合PBC病程早期特点。结论 M2-IgM是PBC产生较早的特异性抗体， M2-IgG产生相对滞后；在AMA-IgG和M2-IgG阴性的PBC患者中， M2-IgM检出率与ACA-IgG密切相关，认为ACA-IgG阳性人群可能是PBC的易发人群，ACA-IgG检测对PBC早期诊断有重要临床意义。
Objective The aim of this study is to analyze the association between IgM anti-mitochon-drial antibody subtypeⅡ（AMA-M2-IgM） and the anti-centromere antibody IgG （ACA-IgG） in primary biliary cirrhosis （PBC） patients, and to investigate the clinical significance of M2-IgM and ACA-IgG in the diagnosis of PBC. Methods We selected 36 cases of PBC patients as research subjects whose AMA-IgG and AMA-M2-IgG were both negative. The M2-IgM positive rate in the ACA-IgG positive group and negative group was compared. We also analyzed the course of disease, pathological changes and the positive conversion rate of M2-IgG between the M2-IgM positive group and negative group. Results There were 9 cases of M2-IgM positive patients （64%） and 5 cases of M2-IgM negative patients （36%） in the ACA-IgG positive group. In the ACA-IgG negative group we found 3 cases of M2-IgM positive patients （14%） and 19 cases of M2-IgM negative patients （86%）. So the M2-IgM positive rate in the ACA-IgG positive group was significantly higher than that of the ACA-IgG negative group （P=0.003）. According to the tracking detection results, the M2-IgG positive conversion rate in the M2-IgM positive group was 67% （8 patients）, which was significantly higher than the M2-IgM negative group 8%, （2 patients） （P=0.001）. Conclusion M2-IgM is a specific antibody for PBC in the early stage, which presents earlier than M2-IgG. In the PBC patients whose AMA-IgG and AMA-M2-IgG antibodies are both negative, the M2-IgM positive rate is closely related to the ACA-IgG, so the ACA-IgG detection is very important in the early diagnosis of PBC. Therefore, we speculated that patients with ACA-IgG antibody are more susceptible to PBC.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2015年第6期389-391,共3页
Chinese Journal of Rheumatology
