CAJ | 학술논문

目的通过对抗线粒体抗体(AMA)-M2型阳性体检人群原发性胆汁性肝硬化(PBC)相关指标的分析,揭示PBC早期主要临床症状及体征的分布状况. 方法对20 970例健康体检者进行调查,采用间接免疫荧光法检测抗核抗体(ANA);采用免疫印迹法检测AMA-M2.率的比较用x2检验,P＜ 0.05为差异有统计学意义. 结果 ANA滴度＞1∶320阳性1 243例,其中AMA-M2阳性156例,阳性率0.74％,男性阳性率为0.3 (32/10 550),女性阳性率为1.2％ (124/10 420),二者差异有统计学意义(x2=55.85,P＜0.05);肝功能异常66例,其中碱性磷酸酶升高58例,可明确诊断为PBC;血常规异常72例;有胆囊疾病病史者47例,糖尿病史者49例,过敏史者22例;有腹部不适者75例,乏力者38例,黄疸者3例,瘙痒者11例.与对照组比较,差异均有统计学意义.结论亚健康人群如发现血常规及肝功能异常应尽早行AMA-M2等自身抗体检测,以利于PBC早期诊断及病情控制,提高患者生活质量,延长寿命.
목적 통과대항선립체항체(AMA)-M2형양성체검인군원발성담즙성간경화(PBC)상관지표적분석,게시PBC조기주요림상증상급체정적분포상황. 방법 대20 970례건강체검자진행조사,채용간접면역형광법검측항핵항체(ANA);채용면역인적법검측AMA-M2.솔적비교용x2검험,P＜ 0.05위차이유통계학의의. 결과 ANA적도＞1∶320양성1 243례,기중AMA-M2양성156례,양성솔0.74％,남성양성솔위0.3 (32/10 550),녀성양성솔위1.2％ (124/10 420),이자차이유통계학의의(x2=55.85,P＜0.05);간공능이상66례,기중감성린산매승고58례,가명학진단위PBC;혈상규이상72례;유담낭질병병사자47례,당뇨병사자49례,과민사자22례;유복부불괄자75례,핍력자38례,황달자3례,소양자11례.여대조조비교,차이균유통계학의의.결론 아건강인군여발현혈상규급간공능이상응진조행AMA-M2등자신항체검측,이리우PBC조기진단급병정공제,제고환자생활질량,연장수명.
Objective To explore the distribution of the main clinical symptoms and signs of primary biliary cirrhosis (PBC) in a population of individuals with positivity for anti-mitochondrial antibody-M2 (AMA-M2).Methods A total of 20 970 persons who participated in routine health examinations at our hospital were tested for presence and level of antinuclear antibodies (ANAs) using an indirect immunofluorescence (IIF) assay and of AMA-M2 by western blotting.The chi-square test was used for statistical analysis.Results Titers of ANAs ＞ 1∶320 were detected in 1 243 of all the study participants,with 156 of those individuals having detectable AMA-M2.The overall rate ofAMA-M2 positivity was 0.74％,with a significantly higher rate among female subjects (males:0.3％ (32/10 550) vs.females:1.2％ (124/10 420);x2 =55.85,P ＜ 0.05).Among the AMA-M2-positive population there were 66 cases of abnormal liver function,58 cases of increased alkaline phosphatase,72 cases of abnormal findings for routine blood testing,47 cases of gallbladder disease history,49 cases of diabetes history,22 cases of allergy,75 cases of abdominal discomfort,38 cases of weakness,3 cases of jaundice,and 11 cases of pruritus.There were significant differences between the AMA-M2-negative individuals and the AMA-M2-positive individuals.Conclusion Among the general population,individuals with substandard states of health,such as those with abnormal findings in routine blood tests and abnormal liver function,should be screened for AMA-M2.This screening will facilitate early diagnosis of PBC and timely initiation of disease management,improving the patient's life quality of life and prolonging their life.