摘要
目的探讨肝病自身抗体抗线粒体抗体(AMA)、抗线粒体抗体-M2型(AMA-M2)、抗gp210抗体、抗sp100抗体对原发性胆汁性胆管炎(PBC)的诊断价值及预后价值。方法回顾性分析2020年3月至2022年2月于福建医科大学附属泉州第一医院就诊的88例PBC患者、100例非PBC肝功能不全者和140名健康对照者的临床资料,计算AMA、AMA-M2、抗gp210抗体和抗sp100抗体诊断PBC的灵敏度、特异度、AUC曲线下面积,并进一步比较各抗体阳性组和阴性组PBC患者肝脏酶学指标丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和γ-谷氨酰转移酶(γ-GGT)和免疫球蛋白IgG、IgM水平差异是否显著。结果AMA、AMA-M2、抗gp210抗体、抗sp100抗体诊断PBC的灵敏度分别为70.45%、77.27%、39.77%和17.05%,特异度分别为90.42%、92.08%、95.42%、96.67%,AUC曲线下面积分别为0.8044,0.8468,0.6759,0.5686。PBC患者中AMA、AMA-M2阳性组与阴性组间AST、ALT、ALP、GGT、IgG和IgM水平差异无统计学意义(P>0.05),而抗gp210抗体、抗sp100抗体阳性组ALP、GGT和IgM水平高于阴性组,差异有统计学意义(P<0.05)。抗gp210抗体在肝硬化组与非肝硬化组的阳性率分别为60.87%(14/23)和32.31%(21/65),差异有统计学意义(P<0.05)。结论AMA、AMA-M2、抗gp210抗体、抗sp100抗体对诊断PBC均具有较高的特异度,但敏感度不一,其中AMA-M2对PBC的诊断效能较好;抗gp210抗体、抗sp100抗体与PBC疾病活动度有关,对PBC具有一定的预测价值。
Objective To investigate the diagnostic and prognostic value of liver autoantibodies which are AMA,AMA-M2,anti-gp210 antibody and anti-sp100 antibody in primary biliary cholangitis.Methods A retrospective analysis was performed on the clinical data of 88 patients with PBC,100 cases of non-PBC hepatic insufficiency and 140 healthy controls in Quanzhou First Hospital affiliated to Fujian Medical University from March 2020 to February 2022.The sensitivity,specificity and area under the AUC curve of AMA,AMA-M2,anti-gp210 antibody and anti-sp100 antibody for the diagnosis of PBC were calculated,and the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyl transferase(γ-GGT)and immunoglobulin IgG and IgM levels were significantly compared between the positive and negative groups of PBC.Results The sensitivity of AMA,AMA-M2,anti-gp210 antibody and anti-sp100 antibody for the diagnosis of PBC was 70.45%,77.27%,39.77%and 17.05%,the specificity was 90.42%,92.08%,95.42%and 96.67%,and the area under the AUC curve was respectively 0.8044,0.8468,0.6759 and 0.5686.There were no significant differences in the levels of AST,ALT,ALP,GGT,IgG and IgM between the positive and negative groups of AMA,AMA-M2 in PBC patients(P>0.05),while the levels of ALP,GGT and IgM were statistically significant between the positive and negative groups of anti-gp210 antibody and anti-sp100 antibody(P<0.05).The positive rate of anti-gp210 antibody in cirrhosis group and non-cirrhosis group was 60.87%(14/23)and 32.31%(21/65),respectively,the same as the difference was statistically significant(P<0.05).Conclusion AMA,AMA-M2,anti-gp210 antibody and anti-sp100 antibody have high specificity for the diagnosis of PBC,but the sensitivitys are different,among which AMA-M2 has better diagnostic efficacy for PBC.Anti-gp210 antibody and anti-sp100 antibody are related to the disease activity of PBC and have certain predictive value for PBC.
作者
苏春燕
吴聪莲
白羽
SU Chunyan;WU Conglian;BAI Yu(Department of Laboratory Medicine,the First Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)
出处
《中国医药指南》
2023年第10期10-13,共4页
Guide of China Medicine
基金
泉州市科技局计划项目(NO:2020N026S)。
关键词
原发性胆汁性胆管炎
抗线粒体抗体
抗线粒体抗体-M2型
抗gp210抗体
抗sp100抗体
Primary biliary cholangitis
Anti-mitochondrial antibody
Anti-mitochondrial antibody M2 subtype
Anti-transmembrane glycoprotein 210 antibody
Resistant to soluble acidic phosphorylated nucleoprotein 100 antibody
