dsDNA抗体检测对自身免疫性肝炎的临床意义

目的 探讨dsDNA抗体对自身免疫性肝炎(autoimmune hepatitis,AIH)的临床意义.方法 收集临床诊断为AIH的患者血清43例,采用免疫印迹法检测dsDNA抗体.按dsDNA抗体阳性与否,分为抗体阳性组及抗体阴性组,比较dsDNA抗体阳性组与阴性组临床生化指标及预后的差异.结果 43例AIH患者中dsDNA抗体阳性13例(30.23%).13例dsDNA抗体阳性AIH患者平均天冬氨酸转氨酶(AST)为(647.56±529.77)IU/ml,总胆红素(TBIL)为(10.81±8.08)ms/L,明显高于对照组(P<0.05),凝血酶原活动度(PTA)为75.72%4±30.23%,明显低于对照组(P<0.05).dsDNA抗体阳性AIH患者组肝硬化发生率为61.5%(8/13),明显高于对照组(P<0.05).对两组患者出现肝硬化的时间作生存分析,发现dsDNA抗体阳性AIH患者发生肝硬化的时间明显短于对照组(P=0.0074).结论 抗dsDNA阳性的AIH患者肝损伤较重,病情进展较迅速,预后较差.

Significance of antibody to double-stranded DNA in autoimmune hepatitis

Objective To study the significance of antibody to double-stranded DNA (anti- dsDNA) in autoimmune hepatitis(AIH). Methods Anti-dsDNA were detected by immunological blotting. According to the anti-dsDNA, the patients were separated two groups: anti-dsDNA positive group and anti-dsDNA negative group. The clinical characteristics were compared between anti-dsDNA positive AIH group and negative group. Results Among the 43 serum samples, 13 (30.23%) eases with anti-dsDNA positive were found. The average level of AST(aspartate aminotransferase) and TBIL(total bilirubin) were (647.56 ±529.77) IU/L and (10.81± 8.08) rag/L, respectively, which was higher than that of the control group (P < 0.05). PTA (prothrombin activity) was 75.72%± 30.23 %, lower than that of the control group(P < 0.05). The liver cirrhosis rate in the anti-dsDNA positive AIH group was 61.5% (8/13), ,significantly higher than that of the control group. The time from the onset to liver cirrhosis was significantly shorter in an- ti-dsDNA positive AIH group than that of control group by the survival analysis and log rank test (P = 0. 0074). Conclusion AIH patients with anti-dsDNA positive generally associate with the serious liver damage, and prognosis is worse.