CAJ | 학술논문

目的探讨3种自身抗体(抗-线粒体M2亚型、抗-gp210、抗-Sp100)的联合检测在原发性胆汁性肝硬化中的诊断价值.方法选择2000例隐匿性肝炎患者,根据疾病诊断分为原发性胆汁性肝硬化(PBC)组129例(6.45%)、自身免疫性肝炎(AIH)组205例(10.25%)、AIH-PBC重叠综合征组15例(0.75%)、脂肪肝组514例(25.70%)、药物性肝炎组379例(18.96%)、其他不明原因肝炎组758例(37.90%).选择同期健康者15例作为对照组.采用ELISA法检测2000例隐匿性肝炎患者血清中抗-线粒体M2亚型(AMA-M2)、抗-核包膜蛋白gp210(anti-gp210)、抗-可溶性酸性磷酸化核蛋白Sp100(anti-Sp100),结合自身免疫性肝病、脂肪性肝病、药物性肝病等疾病的诊断标准进行筛查分析.结果 PBC组AMA-M2、抗-gp210、抗-Sp100阳性率分别为97.67%(126/129)、41.86%(54/129)、27.91%(36/129),抗-gp210、抗-Sp100两者同时出现的阳性率为9.30%(12/129).12例抗-gp210和抗Sp100抗体阳性的不明原因肝炎患者经肝组织活检后有3例诊断为PBC.PBC组有62.80%(81/129)的AMA-M2抗体滴度水平在1︰800以上,有13.95%(18/129)的AMA-M2抗体滴度水平为1︰25~100,有9.30%(12/129)的AMA-M2抗体滴度水平为1︰100~200.结论 AMA-M2阳性仍是诊断PBC的主要诊断指标,AMA-M2、抗-gp210、抗-Sp100的联合检测对PBC的诊断具有较高的应用价值,对筛查其他自身免疫肝病有较好的辅助作用.
목적탐토3충자신항체(항-선립체M2아형、항-gp210、항-Sp100)적연합검측재원발성담즙성간경화중적진단개치.방법선택2000례은닉성간염환자,근거질병진단분위원발성담즙성간경화(PBC)조129례(6.45%)、자신면역성간염(AIH)조205례(10.25%)、AIH-PBC중첩종합정조15례(0.75%)、지방간조514례(25.70%)、약물성간염조379례(18.96%)、기타불명원인간염조758례(37.90%).선택동기건강자15례작위대조조.채용ELISA법검측2000례은닉성간염환자혈청중항-선립체M2아형(AMA-M2)、항-핵포막단백gp210(anti-gp210)、항-가용성산성린산화핵단백Sp100(anti-Sp100),결합자신면역성간병、지방성간병、약물성간병등질병적진단표준진행사사분석.결과 PBC조AMA-M2、항-gp210、항-Sp100양성솔분별위97.67%(126/129)、41.86%(54/129)、27.91%(36/129),항-gp210、항-Sp100량자동시출현적양성솔위9.30%(12/129).12례항-gp210화항Sp100항체양성적불명원인간염환자경간조직활검후유3례진단위PBC.PBC조유62.80%(81/129)적AMA-M2항체적도수평재1︰800이상,유13.95%(18/129)적AMA-M2항체적도수평위1︰25~100,유9.30%(12/129)적AMA-M2항체적도수평위1︰100~200.결론 AMA-M2양성잉시진단PBC적주요진단지표,AMA-M2、항-gp210、항-Sp100적연합검측대PBC적진단구유교고적응용개치,대사사기타자신면역간병유교호적보조작용.
@@@@Objective To evaluate the diagnostic value of anti-mitochondrial antibodies-M2 subtype, anti-gp210, anti-Sp100 by detecting in patients with primary biliary cirrhosis (PBC). Methods Serum samples were detected for AMA-M2, anti-gp210 and anti-Sp100 by immunoblotting assay in 2000 patients with cryptogenic hepatitis, and other 15 healthy individuals were taken as control group. Patients were diagnosed as PBC (129 cases, 6.45%), AIH (205 cases, 10.25%), AIH-PBC overlap syndrome (15 cases, 0.75%), fatty liver (514 cases, 25.70%), drug-induced hepatitis (379 cases, 18.96%), and other unexplained hepatitis (758 cases, 37.90%). Results The positive rates of these three antibodies were 97.67%(126/129), 41.86%(54/129), 27.91%(36/129), respectively. The simultaneous occurrence rate of anti-gp210 and anti-Sp100 was 9.30% (12/129).There were 12 cases with positive anti-gp210 and anti-Sp100 antibody, 3 of whom were diagnosed as PBC through liver puncture. In PBC group, patients with AMA-M2 antibody titer high than 1︰800 accounted for 62.80%(81/129), while the percents of patients with titers ranged from 1︰25 to 1︰100 and from 1︰100 to 1︰200 were 13.95%(18/129) and 30%(12/129), respectively. Conclusions AMA-M2 antibody is still the main marker for PBC diagnosis. The combined detection of AMA-M2 antibody, anti-gp210, anti-Sp100 in PBC have a higher value and play a good supporting role in screening other autoimmune liver diseases.