中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2013年
5期
359-362
,共4页
唐映梅%包维民%尤丽英%江洪娟%杨晋辉
唐映梅%包維民%尤麗英%江洪娟%楊晉輝
당영매%포유민%우려영%강홍연%양진휘
肝硬化,胆汁性%诊断%临床研究%抗体%SP100
肝硬化,膽汁性%診斷%臨床研究%抗體%SP100
간경화,담즙성%진단%림상연구%항체%SP100
Liver cirrhosis,biliary%Diagnosis%Clinical research%Antibodies%SP100
目的 了解表达SP100抗体的原发性胆汁性肝硬化(PBC)患者的临床特点,为临床上诊断和随访PBC患者提供依据. 方法 回顾性分析70例PBC患者,分为抗SP100阳性组12例、抗SP100阴性组58例,比较其症状、肝功能、免疫学指标及肝病理组织学等特征.用SPSS11.5统计软件包进行数据的统计学处理,两组间均数比较采用成组资料t检验,非正态资料采用秩和检验,等级资料采用Ridit分析. 结果 抗SP100阳性组和抗SP100阴性组,在年龄、性别、临床表现、抗线粒体抗体M2亚型(AMA-M2)表达,差异均无统计学意义.碱性磷酸酶、γ-谷氨酰转肽酶中位数和IgM平均值抗SP100阳性组分别为466 U/L、728 U/L和(4.25±2.86) g/L,抗SP100阴性组分别为163U/L、154 U/L和(2.81±2.15) g/L,抗SP100阳性组碱性磷酸酶、γ-谷氨酰转肽酶和IgM水平均高于抗SP100阴性组,Z值分别为3.71和3.38、t=2.06,P值均＜0.05,差异有统计学意义.40例AMA-M2阴性的PBC患者中抗核抗体阳性18例,占45％,抗SP100阳性8例,占20％,AMA-M2阴性的PBC患者中抗核抗体阳性率高于抗SP100阳性率,P=0.021.AMA-M2表达在抗SP100阳性组和抗SP100阴性组间差异无统计学意义.病理组织学上,PBC各期患者均有SP100抗体表达.结论 表达SP100抗体的PBC患者的临床特征类似于未表达SP100抗体者；对SP100抗体表达的PBC患者更应重视随访.
目的 瞭解錶達SP100抗體的原髮性膽汁性肝硬化(PBC)患者的臨床特點,為臨床上診斷和隨訪PBC患者提供依據. 方法 迴顧性分析70例PBC患者,分為抗SP100暘性組12例、抗SP100陰性組58例,比較其癥狀、肝功能、免疫學指標及肝病理組織學等特徵.用SPSS11.5統計軟件包進行數據的統計學處理,兩組間均數比較採用成組資料t檢驗,非正態資料採用秩和檢驗,等級資料採用Ridit分析. 結果 抗SP100暘性組和抗SP100陰性組,在年齡、性彆、臨床錶現、抗線粒體抗體M2亞型(AMA-M2)錶達,差異均無統計學意義.堿性燐痠酶、γ-穀氨酰轉肽酶中位數和IgM平均值抗SP100暘性組分彆為466 U/L、728 U/L和(4.25±2.86) g/L,抗SP100陰性組分彆為163U/L、154 U/L和(2.81±2.15) g/L,抗SP100暘性組堿性燐痠酶、γ-穀氨酰轉肽酶和IgM水平均高于抗SP100陰性組,Z值分彆為3.71和3.38、t=2.06,P值均＜0.05,差異有統計學意義.40例AMA-M2陰性的PBC患者中抗覈抗體暘性18例,佔45％,抗SP100暘性8例,佔20％,AMA-M2陰性的PBC患者中抗覈抗體暘性率高于抗SP100暘性率,P=0.021.AMA-M2錶達在抗SP100暘性組和抗SP100陰性組間差異無統計學意義.病理組織學上,PBC各期患者均有SP100抗體錶達.結論 錶達SP100抗體的PBC患者的臨床特徵類似于未錶達SP100抗體者；對SP100抗體錶達的PBC患者更應重視隨訪.
목적 료해표체SP100항체적원발성담즙성간경화(PBC)환자적림상특점,위림상상진단화수방PBC환자제공의거. 방법 회고성분석70례PBC환자,분위항SP100양성조12례、항SP100음성조58례,비교기증상、간공능、면역학지표급간병리조직학등특정.용SPSS11.5통계연건포진행수거적통계학처리,량조간균수비교채용성조자료t검험,비정태자료채용질화검험,등급자료채용Ridit분석. 결과 항SP100양성조화항SP100음성조,재년령、성별、림상표현、항선립체항체M2아형(AMA-M2)표체,차이균무통계학의의.감성린산매、γ-곡안선전태매중위수화IgM평균치항SP100양성조분별위466 U/L、728 U/L화(4.25±2.86) g/L,항SP100음성조분별위163U/L、154 U/L화(2.81±2.15) g/L,항SP100양성조감성린산매、γ-곡안선전태매화IgM수평균고우항SP100음성조,Z치분별위3.71화3.38、t=2.06,P치균＜0.05,차이유통계학의의.40례AMA-M2음성적PBC환자중항핵항체양성18례,점45％,항SP100양성8례,점20％,AMA-M2음성적PBC환자중항핵항체양성솔고우항SP100양성솔,P=0.021.AMA-M2표체재항SP100양성조화항SP100음성조간차이무통계학의의.병리조직학상,PBC각기환자균유SP100항체표체.결론 표체SP100항체적PBC환자적림상특정유사우미표체SP100항체자；대SP100항체표체적PBC환자경응중시수방.
Objective To evaluate the clinical features of patients with primary biliary cirrhosis (PBC) and positive expression of SP100 autoantibody in order to generate a clinical screening profile that may help to increase early diagnosis and timely initiation of therapy.Methods The clinical data of 70 patients who were diagnosed with PBC by liver biopsy between January 2006 to December 2009 at the Second Affiliated Hospital of Kunming Medical University of Hepatobiliary and Pancreatic Medicine were retrospectively collected for analysis.The patients were divided according to expression of anti-SP100:positive patients,n =12; negative patients,n =58.The groups were comparatively analyzed for differences in clinical,biochemical,immunological,and histopathological parameters.Normally distributed data was compared by t-test,and non-normally data was compared by rank-sum test.Results There was no significant difference in age among the SP100-positive and SP100-negative patients (51.6 ± 9.5 vs.50.0 ± 14.7 years,P ＞ 0.05).The SP100-positive group had significantly more women (80.0％ vs.61.9％,x2 =0.32,P ＞ 0.05) and more patients with atypical symptoms (18.2％ vs.13.8％) but the difference of the latter did not reach statistical significance.The SP100-positive group had significantly higher levels of alkaline phosphatase (ALP; 466 vs.163 U/L,Z =3.71),gammaglutamyl-transpeptdase (GGT; 728 vs.154 U/L,Z =3.38),and immunoglobulin M (IgM; 4.25 ± 2.86 vs.2.81 ± 2.15,t=2.06,P ＜ 0.05).Forty of the total patients tested negative for antimitochondrial (AMA)-M2 antibodies,and eight of those were SP100-positive (20.0％) while 18 were antinuclear (ANA) antibody-positive (45.0％).There were significantly more AMA-M2-negative/ANA-positive patients than SP 100-positive patients (P =0.021).Anti-SP 100expression was not associated with the pathological stage of PBC (R1 =5.500,P ＞ 0.05).Conclusion SP100-positive PBC may show a bias towards the female sex,and may be characterized by enhanced serum levels of ALP,GGT,and IgM.Further clinical differences may manifest as the disease progresses,and changes in autoantibodies' expression and liver function markers should be carefully monitored in follow-up.
