中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2009年
12期
905-909
,共5页
卢建溪%钱师宇%舒欣%李刚
盧建溪%錢師宇%舒訢%李剛
로건계%전사우%서흔%리강
肝硬化%胆汁性%酶联免疫吸附测定%抗线粒体抗体
肝硬化%膽汁性%酶聯免疫吸附測定%抗線粒體抗體
간경화%담즙성%매련면역흡부측정%항선립체항체
Liver cirrhosis%bilialy%Enzyme-linked immunosorbent assay%Antimitochondrial antibodies
目的 评价以新型天然M2抗原和BPO融合蛋白M2-3E(BPO)为靶抗原的酶联免疫吸附(ELISA)法(抗-M2-3E ELISA)检测抗线粒体抗体M2亚型(AMA-M2)IgG和IgA抗体在原发性胆汁性肝硬化(PBC)诊断中的敏感性、特异性以及其临床意义.方法 分别用间接免疫荧光法(IFL)、以丙酮酸脱氢酶复合体为靶抗原的ELISA法(抗-PDC ELlSA),抗-M2-3E ELISA法检测107例PBC患者,87例疾病对照患者和26名健康体检者的AMA-M2 IgG和(或)IgA抗体.检测ALT,AST,总胆红素、白蛋白、Y-谷氨酰转肽酶、碱性磷酸酶、血清肌酐、IgG、IgM及IgA.对于符合正态分布的计量数据采用t检验,不符合正态分布者采用秩和检验. 结果 107例PBC患者抗-M2-3E ELISA法AMA-M2 IgG的检出率(90.6%)高于IFL法(81.3%)和抗-PDCELISA法(72.9%),t值分别为4.32和6.03,P值均<0.05.抗M2-3E ELISA法检测AMA-M2 IgA的检出率为55.1%,特异性为97.2%,而总体AMA-M2 IgG和(或)IgA的检出率为92.5%,特异性为95.2%.20例IFL检测AMA-M2 IgG为阴性的PBC患者中,抗-M2-3E ELISA法检出率为45%,AMA-M2 IgG和(或)IgA的检出率为55%,抗-M2-3E ELISA可以在超过一半的IFL阴性的患者中检出AMA-M2 IgG和(或)IgA.AMA-M2 IgG呈阳性的患者(97例)比呈阴性的患者(10例)有更加严重的组织学变化和更高的IgG,IgM和碱性磷酸酶水平.结论 抗-M2-3E ELISA法具有比IFL和抗-PDC ELISA法更高的敏感性和特异性,可作为第一轮AMA-M2的筛查.AMA-M2 IgG阳性可能说明该PBC患者有更加严重的疾病,但是AMA-M2 IgG和IgA都不能单独用于诊断PBC.
目的 評價以新型天然M2抗原和BPO融閤蛋白M2-3E(BPO)為靶抗原的酶聯免疫吸附(ELISA)法(抗-M2-3E ELISA)檢測抗線粒體抗體M2亞型(AMA-M2)IgG和IgA抗體在原髮性膽汁性肝硬化(PBC)診斷中的敏感性、特異性以及其臨床意義.方法 分彆用間接免疫熒光法(IFL)、以丙酮痠脫氫酶複閤體為靶抗原的ELISA法(抗-PDC ELlSA),抗-M2-3E ELISA法檢測107例PBC患者,87例疾病對照患者和26名健康體檢者的AMA-M2 IgG和(或)IgA抗體.檢測ALT,AST,總膽紅素、白蛋白、Y-穀氨酰轉肽酶、堿性燐痠酶、血清肌酐、IgG、IgM及IgA.對于符閤正態分佈的計量數據採用t檢驗,不符閤正態分佈者採用秩和檢驗. 結果 107例PBC患者抗-M2-3E ELISA法AMA-M2 IgG的檢齣率(90.6%)高于IFL法(81.3%)和抗-PDCELISA法(72.9%),t值分彆為4.32和6.03,P值均<0.05.抗M2-3E ELISA法檢測AMA-M2 IgA的檢齣率為55.1%,特異性為97.2%,而總體AMA-M2 IgG和(或)IgA的檢齣率為92.5%,特異性為95.2%.20例IFL檢測AMA-M2 IgG為陰性的PBC患者中,抗-M2-3E ELISA法檢齣率為45%,AMA-M2 IgG和(或)IgA的檢齣率為55%,抗-M2-3E ELISA可以在超過一半的IFL陰性的患者中檢齣AMA-M2 IgG和(或)IgA.AMA-M2 IgG呈暘性的患者(97例)比呈陰性的患者(10例)有更加嚴重的組織學變化和更高的IgG,IgM和堿性燐痠酶水平.結論 抗-M2-3E ELISA法具有比IFL和抗-PDC ELISA法更高的敏感性和特異性,可作為第一輪AMA-M2的篩查.AMA-M2 IgG暘性可能說明該PBC患者有更加嚴重的疾病,但是AMA-M2 IgG和IgA都不能單獨用于診斷PBC.
목적 평개이신형천연M2항원화BPO융합단백M2-3E(BPO)위파항원적매련면역흡부(ELISA)법(항-M2-3E ELISA)검측항선립체항체M2아형(AMA-M2)IgG화IgA항체재원발성담즙성간경화(PBC)진단중적민감성、특이성이급기림상의의.방법 분별용간접면역형광법(IFL)、이병동산탈경매복합체위파항원적ELISA법(항-PDC ELlSA),항-M2-3E ELISA법검측107례PBC환자,87례질병대조환자화26명건강체검자적AMA-M2 IgG화(혹)IgA항체.검측ALT,AST,총담홍소、백단백、Y-곡안선전태매、감성린산매、혈청기항、IgG、IgM급IgA.대우부합정태분포적계량수거채용t검험,불부합정태분포자채용질화검험. 결과 107례PBC환자항-M2-3E ELISA법AMA-M2 IgG적검출솔(90.6%)고우IFL법(81.3%)화항-PDCELISA법(72.9%),t치분별위4.32화6.03,P치균<0.05.항M2-3E ELISA법검측AMA-M2 IgA적검출솔위55.1%,특이성위97.2%,이총체AMA-M2 IgG화(혹)IgA적검출솔위92.5%,특이성위95.2%.20례IFL검측AMA-M2 IgG위음성적PBC환자중,항-M2-3E ELISA법검출솔위45%,AMA-M2 IgG화(혹)IgA적검출솔위55%,항-M2-3E ELISA가이재초과일반적IFL음성적환자중검출AMA-M2 IgG화(혹)IgA.AMA-M2 IgG정양성적환자(97례)비정음성적환자(10례)유경가엄중적조직학변화화경고적IgG,IgM화감성린산매수평.결론 항-M2-3E ELISA법구유비IFL화항-PDC ELISA법경고적민감성화특이성,가작위제일륜AMA-M2적사사.AMA-M2 IgG양성가능설명해PBC환자유경가엄중적질병,단시AMA-M2 IgG화IgA도불능단독용우진단PBC.
Objective To evaluate the sensitivity and the specificity of Anti-M2-3E ELISA for the detection of lgG-and IgA-specific isotypes of antimitochondrial antibody(AMA),and to investigate the significance of antimitochondriai IgA and IgG in the diagnosis of primary biliary cirrhosis(PBC).Methods Sera were collected from 107 PBC patients,87 disease controls and 26 healthy controls,and the antimitochondrial antibodies(IgG and IgA)were detected using indirect immunofluorescence(IFL),AntiPDC ELISA and Anti.M2-3E ELISA.Results The AMA IgG positive rate in PBC patients was 90.6% detected by Anti-M2-3E ELISA,which is significantly higher than that(81.3%)detected by IFL(t=4.32,P<0.05)and that(72.9%)detected by Anti-PDC ELISA (t=6.03,P<0.05).The AMA IgA was positive in 59 of the 107 PBC patients.and 99 of the 107 patients were positive for AMA IgG or/and IgA.9 of the 20 IFL-negative patients were positive for AMA IgG as indicated by Anti-M2-3E ELISA.11 of the 20 IFL-negative patients were positive for AMA IgG or/and IgA as indicated Anti-M2-3E ELISA.Compared to patients negative for IgG AMA,patients positive for lgG AMA had more severe histopathology and higher levels of ALP,IgG,and lgM.Conclusion The IgG and IgA Anti-M2-3E ELISAs ale more sensitive for the AMA detection than IFN and the Anti-PDC ELISA.The presence of AMA IgG is the characteristics of severe PBC.
