中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
3期
971-974
,共4页
王晗%徐军%刘佳%郭静霞%谢娜%赵静%陈霖%宋永继%杨丽华%刘爱霞%李伯安%毛远丽
王晗%徐軍%劉佳%郭靜霞%謝娜%趙靜%陳霖%宋永繼%楊麗華%劉愛霞%李伯安%毛遠麗
왕함%서군%류가%곽정하%사나%조정%진림%송영계%양려화%류애하%리백안%모원려
肝硬化,胆汁性%自身抗体%荧光抗体技术,间接%免疫印迹法
肝硬化,膽汁性%自身抗體%熒光抗體技術,間接%免疫印跡法
간경화,담즙성%자신항체%형광항체기술,간접%면역인적법
Liver cirrhosis,biliary%Autoantibodies%Fluorescent antibody technique,indirect%Immu-noblotting
目的分析抗线粒体M2亚型抗体阳性（ AMA-M2）的原发性胆汁性肝硬化（ PBC）患者免疫学等实验室诊断特点，推进临床PBC的早期诊断和治疗。方法对400例AMA-M2阳性的PBC患者采用间接免疫荧光法检测血清ANA、AMA、SMA、LKM和PCA等5种自身抗体。采用免疫印迹法检测患者血清7种主要肝抗原：Sp100、PML、gp210、LKM-1、LC-1、SLA/LP和Ro-52。应用全自动生化分析仪检测患者ALP、γ-GT等生化指标，全自动血细胞分析仪和凝血分析仪检测患者 WBC、RBC、HGB、PLT 和 PT 等血液学指标。结果患者自身抗体检测：ANA荧光模型主要包括核膜型、多核点型、着丝点型和胞浆颗粒型，阳性率分别为70％、52％、43％、3％。荧光模型组合方式包括：多核点型＋核膜型、着丝点型＋核膜型、着丝点型、多核点型、胞浆颗粒型以及仅AMA阳性者，阳性率分别为42％、28％、15％、10％、3％、2％，荧光滴度均≥1∶320。SMA、PCA、LKM阳性率均低于5％。患者主要肝抗原为Ro-52、gp210、PML和Sp100，阳性率分别为53％、44％、43％、24％，荧光滴度≥1∶320，而LKM-1、LC-1、SLA/LP阳性率均低于5％。 PML、Sp100及Sp100＋PML与gp210的阳性一致率分别为29％、11％、7％。临床血液检测结果显示有41％的患者WBC和RBC降低，53％的患者HGB降低，38％的患者PLT降低，而有42％的患者PT延长。生化检测结果显示有96％和93％的患者ALP和γ-GT升高。结论 AMA-M2阳性的PBC患者具有高滴度、特征性自身抗体荧光模型及自身肝抗原，结合临床血液及生化检测结果将为临床诊断提供重要帮助。
目的分析抗線粒體M2亞型抗體暘性（ AMA-M2）的原髮性膽汁性肝硬化（ PBC）患者免疫學等實驗室診斷特點，推進臨床PBC的早期診斷和治療。方法對400例AMA-M2暘性的PBC患者採用間接免疫熒光法檢測血清ANA、AMA、SMA、LKM和PCA等5種自身抗體。採用免疫印跡法檢測患者血清7種主要肝抗原：Sp100、PML、gp210、LKM-1、LC-1、SLA/LP和Ro-52。應用全自動生化分析儀檢測患者ALP、γ-GT等生化指標，全自動血細胞分析儀和凝血分析儀檢測患者 WBC、RBC、HGB、PLT 和 PT 等血液學指標。結果患者自身抗體檢測：ANA熒光模型主要包括覈膜型、多覈點型、著絲點型和胞漿顆粒型，暘性率分彆為70％、52％、43％、3％。熒光模型組閤方式包括：多覈點型＋覈膜型、著絲點型＋覈膜型、著絲點型、多覈點型、胞漿顆粒型以及僅AMA暘性者，暘性率分彆為42％、28％、15％、10％、3％、2％，熒光滴度均≥1∶320。SMA、PCA、LKM暘性率均低于5％。患者主要肝抗原為Ro-52、gp210、PML和Sp100，暘性率分彆為53％、44％、43％、24％，熒光滴度≥1∶320，而LKM-1、LC-1、SLA/LP暘性率均低于5％。 PML、Sp100及Sp100＋PML與gp210的暘性一緻率分彆為29％、11％、7％。臨床血液檢測結果顯示有41％的患者WBC和RBC降低，53％的患者HGB降低，38％的患者PLT降低，而有42％的患者PT延長。生化檢測結果顯示有96％和93％的患者ALP和γ-GT升高。結論 AMA-M2暘性的PBC患者具有高滴度、特徵性自身抗體熒光模型及自身肝抗原，結閤臨床血液及生化檢測結果將為臨床診斷提供重要幫助。
목적분석항선립체M2아형항체양성（ AMA-M2）적원발성담즙성간경화（ PBC）환자면역학등실험실진단특점，추진림상PBC적조기진단화치료。방법대400례AMA-M2양성적PBC환자채용간접면역형광법검측혈청ANA、AMA、SMA、LKM화PCA등5충자신항체。채용면역인적법검측환자혈청7충주요간항원：Sp100、PML、gp210、LKM-1、LC-1、SLA/LP화Ro-52。응용전자동생화분석의검측환자ALP、γ-GT등생화지표，전자동혈세포분석의화응혈분석의검측환자 WBC、RBC、HGB、PLT 화 PT 등혈액학지표。결과환자자신항체검측：ANA형광모형주요포괄핵막형、다핵점형、착사점형화포장과립형，양성솔분별위70％、52％、43％、3％。형광모형조합방식포괄：다핵점형＋핵막형、착사점형＋핵막형、착사점형、다핵점형、포장과립형이급부AMA양성자，양성솔분별위42％、28％、15％、10％、3％、2％，형광적도균≥1∶320。SMA、PCA、LKM양성솔균저우5％。환자주요간항원위Ro-52、gp210、PML화Sp100，양성솔분별위53％、44％、43％、24％，형광적도≥1∶320，이LKM-1、LC-1、SLA/LP양성솔균저우5％。 PML、Sp100급Sp100＋PML여gp210적양성일치솔분별위29％、11％、7％。림상혈액검측결과현시유41％적환자WBC화RBC강저，53％적환자HGB강저，38％적환자PLT강저，이유42％적환자PT연장。생화검측결과현시유96％화93％적환자ALP화γ-GT승고。결론 AMA-M2양성적PBC환자구유고적도、특정성자신항체형광모형급자신간항원，결합림상혈액급생화검측결과장위림상진단제공중요방조。
Objective To study the immunological characteristics of primary biliary cirrhosis patients with anti-mitochondrial antibody M2 subtype(AMA-M2)positive,for promoting early diagnosis and treatment of PBC. Methods Five kinds of autoantibodies including ANA ,AMA,SMA,LKM and PCA in serum from 400 PBC patients with AMA-M2 positive were analyzed by indirect immunofluorescence assay and seven kinds of liver antigens including Sp100,PML,gp210,LKM-1,LC-1,SLA/LP and Ro-52 were tested by immunoblotting test.Biochemical indicators of ALP and γ-GT were assaied by automatic biochemical analyzer .Clinical hematology indicators of WBC , RBC, HGB, PLT and PT were assaied by automatic blood cell analyzer and automatic coagulation analyzer . Results The patients′main florescence patterns of ANA were nuclear envelope ,multiple nuclear dots ,centromere pattern and cytoplasm particles pattern , the positive rates were 70%, 52%, 43% and 3%.Fluorescent pattern combination models included multiple nuclear dots plus nuclear envelope ,centromere pattern plus nuclear envelope , centromere pattern ,multiple nuclear dots ,cytoplasm particles pattern and only AMA positive pattern .The positive rate of those models were 42%,28%,15%,10%,3%,2%,and the titers were all beyond 1∶320.The positive rate of SMA,PCA,LKM were all less than 5%.The main liver antigens of patiens were Ro-52,gp210,PML,Sp100 and the positive rate were 53%,44%,43%and 24%respectively,and the titers were all beyond 1∶320.The positive rate of other liver antigens including LKM-1,LC-1,SLA/LP were all less than 5%.Positive concordance rate of PML ,Sp100 and Sp100 combined with PML to gp210 were 29%,11% and 7%.The detection of clinical hematology indicators show that in 41%patients WBC and RBC levels reduced abnormally ,in 53% patients and 38% patients the HGB and PLT levels reduced abnormally , while in 42% patients PT levels prolonged abnormally .The detection of biochemical indicators showed that in 96% and 93% patients ALP and γ-GT levels elevated abnormally . Conclusions PBC patients with AMA-M2 positive characterized as high titers-special autoantibodies florescence patterns and liver antigens ,together with abnormal biochemical indicators and clinical hematology indicators would be beneficial to diagnosis of PBC .
