CAJ | 학술논문

目的：探讨肝病患者中抗核仁抗体（ANoAs）出现的特点及其临床意义。方法采用间接免疫荧光法对5506例肝病患者进行抗核抗体（ANA）、抗线粒体抗体（AMA）、抗平滑肌抗体（SMA）等检测，通过镜下 ANA 的核型筛选出抗核仁抗体。结果（1）5506例患者中抗核仁抗体阳性患者为264例（4．8％）。其中64．4％为1∶100（170例）、20．1％为1∶320（53例）、15．5％为≥1000（41例）。部分患者伴有其他自身抗体。（2）在264例抗核仁抗体阳性肝病患者中肝炎为155例、肝硬化为81例和肝癌为28例，病因包括甲、乙、丙型等病毒性感染、药物性、酒精性、自身免疫性等多种原因。抗核仁抗体以低滴度（1∶100）为主，以肝硬化患者的比例稍高（比例分别为：62．6％ VS 70．4％VS 57．1％）；而高滴度抗核仁抗体（≥1∶1000）中以在肝癌患者中较为常见（比例分别为：16．1％ VS 11．1％ VS 25.0％）。（3）抗核仁抗体男性149例（56．4％），女性115例（43．6％）。以40-59岁患者比例较高。结论抗核仁抗体以40-59岁患者较多。在肝炎、肝硬化和肝癌患者血清中均可被检测到，以低滴度（1∶100）为主，肝硬化患者的比例稍高；而在高滴度（≥1∶1000）中，抗核仁抗体以在肝癌患者中较为常见。提示在慢性肝病进展过程中自身免疫的变化可能多集中在与细胞增殖，分裂有关的核仁成份上。
목적：탐토간병환자중항핵인항체（ANoAs）출현적특점급기림상의의。방법채용간접면역형광법대5506례간병환자진행항핵항체（ANA）、항선립체항체（AMA）、항평활기항체（SMA）등검측，통과경하 ANA 적핵형사선출항핵인항체。결과（1）5506례환자중항핵인항체양성환자위264례（4．8％）。기중64．4％위1∶100（170례）、20．1％위1∶320（53례）、15．5％위≥1000（41례）。부분환자반유기타자신항체。（2）재264례항핵인항체양성간병환자중간염위155례、간경화위81례화간암위28례，병인포괄갑、을、병형등병독성감염、약물성、주정성、자신면역성등다충원인。항핵인항체이저적도（1∶100）위주，이간경화환자적비례초고（비례분별위：62．6％ VS 70．4％VS 57．1％）；이고적도항핵인항체（≥1∶1000）중이재간암환자중교위상견（비례분별위：16．1％ VS 11．1％ VS 25.0％）。（3）항핵인항체남성149례（56．4％），녀성115례（43．6％）。이40-59세환자비례교고。결론항핵인항체이40-59세환자교다。재간염、간경화화간암환자혈청중균가피검측도，이저적도（1∶100）위주，간경화환자적비례초고；이재고적도（≥1∶1000）중，항핵인항체이재간암환자중교위상견。제시재만성간병진전과정중자신면역적변화가능다집중재여세포증식，분렬유관적핵인성빈상。
Objective To investigate the features and clinical significance of anti-nucleolar antibodies(ANOAS)in patients with various liver diseases.Methods 5506 serum samples from patients with various liver diseases were detec-ted anti-nuclear antibody(ANA),anti-mitochondrial antibody(AMA),anti-smooth muscle antibody(SMA)by indirect immunofluorescent assay(IIF),The ANOAS pattern is recognized by immunofluorescence using hep-2 cells as sub-strate.Results (1)264 of the 5506 patients with various liver diseases(4.8%)were ANOAS positive,In 264 ANOAS positive patients,64.4% had an ANOAS titer of 1∶100,20.1% 1∶320(53 cases)and 15.5% more than 1∶1 000(41 cases).Some patients were with other autoantibodies.(2)Among 264 ANOAS positive cases,155 with hepatitis,81 with liver cirrhosis(LC)and 28 with hepacellular carcinoma(HCC)the causes including Hepatitis A/B/C virus infec-tion,drug,alohol,autoimmune and other reasons.Low titer(1∶100)of ANOAS was presented in the 3 groups,the high titre(1∶1 000)was more common among hepatitis group,LC group and HCC group(respectively:16.1% vs 11.1% vs 25%).(3)Among 264 ANOAS positive patients,149 were male(56.4%),115 female(43.6%).The Age of ANOAS positive patients was ranging from 40-59 years old.Conclusion The age of ANOAS positive are common in 40-59 years old.low titer(1:100)of ANOAS was presented in the hepatitis group,LC group and HCC group.The high titer(1:1000)are more common founded in HCC group,indicating that autoimmune phenomenon may be concentrated in the nucleolus related with cells proliferation and division related components.