抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

抗乙醇脱氢酶抗体ELISA法的建立及其对自身免疫性肝炎诊断的价值

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.     

自身免疫性肝病和病毒性肝炎患者血清中抗肝抗体检测的临床意义

目的 探讨抗肝原几种抗体在自身免疫性肝病和病毒性肝炎患者血清中检测率及其临床意义。方法 收集江阴市人民医院2010～2014年肝病患者血清,根据疾病诊断分为自身免疫性肝病组48例:包括自身免疫性肝炎(AIH)12例,原发性胆汁性肝硬化(PBC)36例; 病毒性肝炎组62例:包括10例HAV,30例HBV,14例HCV,8例HEV; 以及30例正常对照组。采用免疫印迹法分别检测上述血清标本中抗肝抗原(AMA-M2,LKM-1,LC-1,SLA/LP,GP210,SP100)自身抗体。结果 抗AMA-M2抗体,抗LKM-1抗体,抗LC-1抗体,抗SLA/LP抗体,抗GP210抗体和抗SP100抗体在AIH组的阳性率分别为16.7%(2/12),16.7%(2/12),8.3%(1/12),25%(3/12),0%(0/12)和16.7%(2/12); 在PBC组阳性率分别为83.3%(30/36),0%(0/36),0%(0/36),0%(0/36),44.4%(16/36)和27.8%(10/36); 在乙型肝炎患者中检出1例(3.3%,1/30)AMA-M2阳性,1例(3.3%,1/30)抗GP210抗体阳性,2例(6.7%,2/30)抗SP100抗体阳性; 在丙型肝炎患者中检出1例(7.1%,1/14)抗SP100抗体阳性; 在甲型肝炎、戊型肝炎未检出自身抗体。抗AMA-M2抗体、抗GP210抗体和抗SP100抗体在自身免疫性肝病组阳性率明显高于病毒性肝炎组(χ²值分别为33.9,10.6,8.8,P值均＜0.05)。抗SLA/LP抗体在AIH组阳性率明显高于PBC组(χ²=6.4,P＜0.05)。AMA-M2和抗GP210抗体在PBC组阳性率明显高于AIH组(χ²值分别为15.1和6.1,P＜0.05)。病毒性肝炎患者检出率低,与正常对照组比较差异无统计学意义(χ²=1.1,P＞0.05)。结论 抗肝抗体对自身免疫性肝病的明确诊断及鉴别诊断有重要的临床意义。     

抗去唾液酸糖蛋白受体抗体在慢性肝炎的分布差别研究

目的检测慢性乙型肝炎(简称慢性乙肝)、慢性丙型肝炎(简称慢性丙肝)患者和健康人群血清中抗去唾液酸糖蛋白受体抗体(anti-ASGPR)水平,观察anti-ASGPR与肝炎患者疾病发展的关系。方法选取HBV感染患者60例(慢性乙肝患者30例,慢性乙肝后肝硬化患者30例)、HCV感染患者60例(慢性丙肝患者30例,慢性丙肝后肝硬化患者30例),60例健康体检者为对照组,检测所有研究对象血清中anti-ASGPR、ALT的水平。结果 (1)HBV、HCV感染组血清anti-ASGPR水平均比对照组明显增高,差异均有统计学意义(P0.01)。慢性乙肝后肝硬化组血清anti-ASGPR水平明显比慢性乙肝组高,差异有统计学意义(P0.05)。慢性丙肝后肝硬化组血清anti-ASGPR水平明显比慢性丙肝组高,差异有统计学意义(P0.05)。anti-ASGPR与ALT值无相关性。(2)丙肝组anti-ASGPR血清学水平明显高于乙肝组,差异有统计学意义(P0.01)。结论检测anti-ASGPR有助于临床的鉴别诊断,对治疗和预后具有重要的意义。     

原发性胆汁性肝硬化患者血清自身免疫性肝病相关自身抗体谱的检测及临床意义

目的 通过检测PBC患者血清自身免疫性肝病相关自身抗体,探讨这些抗体在PBC患者中的阳性状况及临床意义.方法 采用IIF法检测247例肝病患者(173例PBC、37例AIH和37例LDC)血清AMA,采用ELISA检测血清自身免疫性肝病相关自身抗体(AMA-M2、抗GP210抗体、抗SP100抗体、抗SLA抗体、抗LC1抗体、抗LKM-1抗体).结果 AMA、AMA-M2、抗GP210抗体、抗SP100抗体、抗LC1抗体、抗SLA抗体和抗LKM-1抗体在173例PBC组的阳性率分别为92.5%(160/173)、86.7%(150/173)、35.8%(62/173)、24.3%(42/173)、0.6%(1/173)、O%(0/173)、0.6%(1/173),在37例AIH组的阳性率分别为18.9%(7/37)、5.4%(2/37)、8.1%(3/37)、13.5%(5/37)、0%(0/37)、5.4%(2/37)、2.7%(1/37),在37例LDC组的阳性率分别为5.4%(2/37)、2.7%(1/37)、5.4%(2/37)、10.8%(4/37)、0%(0/37)、0%(0/37)、0%(0/37).AMA、AMA-M2和抗GP210抗体在PBC患者的阳性率显著高于AIH患者x~2值分别为101.3,100.8和11.0,P均<0.01).而抗SLA抗体在AIH患者阳性率高于PBC患者(x~2=9.4,P<0.01).抗GP210抗体阳性PBC患者ALT、TBIL、DBIL、0GT和ALP水平显著高于阴性患者(U值分别为1212.0、1199.0、1218.0、1074.0、1030.0,P均<0.01).AMA阳性PBC患者IgM水平显著高于阴性患者(U=94.0,P<0.05).结论 抗LC1抗体、抗SIA抗体和抗LkM-1抗体在PBC和AIH中阳性率较低,筛查这3种抗体的临床意义可能不大.抗GP210抗体与PBC患者的肝功能损伤有关,AMA与PBC患者的免疫功能相关,临床筛查抗GP210抗体和AMA对PBC诊断有重要意义.     

原发性胆汁性胆管炎患者血清自身抗体及生化指标的特征分析

目的 探讨原发性胆汁性胆管炎(PBC)患者血清自身抗体及生化指标的特征及临床意义。方法 采用间接免疫荧光法检测64例PBC,81例病毒性肝病,50例健康体检者三组血清中的抗核抗体(ANA)、抗线粒体抗体(AMA); 采用免疫印迹法检测三组的自身免疫肝病抗体(AMA-M2,M2-3E,抗Sp100抗体,抗PML抗体,抗gp210抗体,抗LKM-1抗体,抗LC-1抗体,抗SLA/LP 抗体,Ro52); 采用全自动生化分析仪检测其生化指标。结果 PBC组ANA和AMA阳性率明显高于病毒性肝病组,差异有统计学意义(χ2 =56.07,54.72,均P<0.01); PBC组自身免疫肝病抗体(AMA-M2,M2-3E,抗Sp100抗体,抗gp210抗体,Ro52)阳性率与病毒性肝病组比较,差异有统计学意义(χ2=9.06～98.70,均P<0.01); PBC组生化指标丙氨酸氨基转移酶(ALT)与病毒性肝病组比较,差异无统计学意义(F=6.069,P>0.05),其余总胆红素(TBIL)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和谷氨酰转肽酶(GGT)、总胆固醇(TC)与病毒性肝病组及健康对照组比较差异均有统计学意义(F=6.069～35.56,均P<0.05); AMA-M2阳性和阴性的PBC患者之间的生化指标比较差异无统计学意义(F=0.425～2.775,P>0.05); 抗gp210抗体阳性患者的TC高于阴性患者,差异有统计学意义(F=4.521,P=0.044)。结论 自身抗体ANA,AMA,AMA-M2,M2-3E,抗Sp100抗体,抗gp210抗体有助于PBC的早期诊断,结合生化指标则有利于PBC和病毒性肝病的鉴别诊断和疗效观察。此外,抗gp210抗体阳性与PBC患者的TC有一定的相关性。     

自身免疫性肝炎患者可溶性肝抗原特异性T淋巴细胞反应特点及其临床意义

目的 分析评价AIH患者SLA特异性T淋巴细胞反应特点.方法 用化学法人工合成SLA序列多肽段作为刺激肽,刺激31例AIH患者(SLA/LP抗体阳性10例,SLA/LP抗体阴性21例)、30例PBC患者、29例病毒性肝炎患者和30名健康人中PBMC,使其分泌干扰素γ(IFN-γ),并采用ELISpot方法观察各组SLA肽特异性T淋巴细胞反应特点.结果 31例MH患者中18例患者PBMC对SLA肽库刺激可诱导分泌IFN-γ,其阳性率58.06%(18/31),PBC、病毒性肝炎患者、健康人阳性率分别为3.33%(1/30)、3.45%(1/29)、0.00%(0/30),AIH患者PBMC受SLA肽库刺激分泌INF-γ阳性率明显高于PBC、病毒性肝病患者及健康人(x2值分别为21.295、20.655、15.988,P均＜0.01).18例AIH患者反应单肽位于SLA中8个抗原簇,包括aa1～44、aa57～132、aa129～180、aa177～196、aa 193～244、aa241～268、aa281～308、aa321～428;平均识别SLA序列单肽宽度为6(2～17)条,显示多克隆性.18例呈阳性反应的AIH患者中14例患者在采集PBMC同时进行肝功能检测,该14例患者识别SLA序列单肽的反应宽度与谷草转氨酶(AST)对数值呈正相关(r=0.539,P＜0.05).结论 SLA肽库可诱导AIH患者外周血PBMC分泌IFN-γ,其反应呈多克隆性,反应宽度间接反映患者肝脏炎症活动程度.     

Autoantibodies to CD69 in patients with chronic hepatitis type C: a candidate marker for predicting the response to interferon therapy

OBJECTIVE: To understand the autoimmunity associated with chronic hepatitis C (CHC), we investigated autoantibodies (autoAbs) to CD69. METHODS: With this aim, we tested the reactivity of serum samples from patients with CHC and asymptomatic carriers of hepatitis C virus (HCV), as well as from patients with chronic hepatitis B (CHB) and autoimmune hepatitis (AIH), to recombinant CD69 molecules. RESULTS: Frequencies of anti-CD69 autoAbs were 38.7% in CHC, 15.8% in AIH and 12.3% in CHB. None of the tested asymptomatic HCV carriers had autoAbs to CD69. It is important clinically that the presence of anti-CD69 autoAbs was found to be associated with a poor response to interferon-alpha (IFN-alpha) therapy. In the epitope analysis, multiple epitopes were mapped on CD69, indicating antigen-driven production of the autoAbs. CONCLUSION: We evidenced existence of anti-CD69 autoAbs in patients with CHC, and found that the anti-CD69 autoAb may have potential for predicting responses to IFN-alpha therapy.     

2013年广水市健康儿童4种疫苗接种后抗体水平监测结果分析

目的：了解该辖区内7～＜13岁健康儿童麻疹、流行性乙型脑炎、脊髓灰质炎、乙型肝炎疫苗免疫效果,为全市制定免疫防控策略及风险评估提供科学依据。方法抽取全市7～＜13岁健康儿童4616例,采用 ELISA 进行4种抗体检测。结果广水市7～＜13岁健康儿童麻疹、脊髓灰质炎、流行性乙型脑炎、乙型肝炎抗体阳性率分别为94．41％、93．07％、93．78％、68．72％,前3种抗体保护水平均在85％以上,4种抗体阳性率比较,差异均有统计学意义（χ2＝1987．08,P＝0．000）。流行性乙型脑炎抗体阳性率在不同年龄段差异无统计学意义（χ2＝10．141,P＝0．071）。麻疹、脊髓灰质炎、乙型肝炎抗体阳性率在不同年龄段差异有统计学意义（χ2＝40．471,P＝0．000;χ2＝25．174,P ＝0．000;χ2＝283．641,P＝0．000）。4种抗体阳性率在不同性别间的差异均无统计学意义（χ2＝0．019,P＝0．889;χ2＝1．017,P＝0．313;χ2＝0．018,P＝0．892;P ＝0．639,P＝0．424）。麻疹、脊髓灰质炎、流行性乙型脑炎在全市17个乡镇／社区间差异无统计学意义（χ2＝0．099,P ＝1．000;χ2＝0．117,P ＝1．000;χ2＝0．134,P＝1．000）。乙型肝炎抗体阳性率在17个乡镇／社区间差异有统计学意义（χ2＝186．179,P ＝0．001）。结论广水市7～＜13岁健康儿童麻疹、脊髓灰质炎、流行性乙型脑炎抗体水平达到了保护率,但乙型肝炎抗体水平有待提高,应继续加强监测工作,强化查种补漏工作。     

CHB患者疾病进程与抑郁症的程度及血清BDNF水平的相关性

目的 研究慢性乙型肝炎(CHB)患者在疾病进展的不同阶段并发抑郁症的程度以及血清脑源性神经营养因子(BDNF)的水平。方法 选择HBV病毒携带者(ASC组)、肝硬化(LC组)和肝癌(HCC组)不同病程的患者126例和40例正常对照为研究对象,采用调查问卷调查研究对象人口学资料,以汉密尔顿抑郁量表(HAMD-17)进行评分和抑郁分级,同时采用ELISA法检测血清BDNF水平。结果 LC组、HCC组离异或丧偶的比率高于对照组(χ²=6.354,11.972; P值均＜0.01); ASC组、LC组、HCC组抑郁严重程度的分布均高于对照组,差异有统计学意义(χ²=16.151,42.150,49.636; P值均＜0.01); 同时,ASC组抑郁严重程度低于LC组和HCC组,差异有统计学意义(χ²=14.345,28.772; P值均＜0.01); ASC,LC,HCC和对照组BDNF((-overx)±s,ng/ml),分别为11.10±3.26,8.66±3.11,7.39±2.52和12.18±2.59,LC组和HCC组血清BDNF水平显著低于ASC组和对照组,差异有统计学意义(P值均＜0.01); CHB病程的进展与HAMD评分存在正相关关系(r=0.719,P＜0.01),与BDNF水平存在负相关关系(r=-0.504,P＜0.01); 血清BDNF水平与HAMD评分存在负相关关系(r=-0.526,P＜0.01)。结论 CHB疾病的进程可使抑郁的程度加重,BDNF水平逐渐降低。提示血清BDNF水平可作为CHB患者心理治疗的实验室参考依据。有望提高临床医生对CHB患者伴随抑郁症发生的识别,提高诊疗效果。     

自身免疫性肝病相关自身免疫性抗体的特征分析及临床应用价值

目的：观察自身免疫性肝病（AILD）相关自身免疫性抗体的特征分析及临床应用价值。方法：临床纳入自身免疫性肝炎（AIH）、原发性胆汁性肝硬化（PBC）以及病毒性肝炎患者作为研究对象,并选取健康体检者作为对照。检测每组患者的相关自身免疫指标。结果：AIH患者血清ANA阳性率明显高于PBC、病毒性肝炎以及对照组（P〈0．05）。PBC患者血PBC患者血清AMA阳性率显著高于AIH组（P〈0．05）。血清ANA在AIH以及PBC患者中均以高低度（1：1000）为主。结论：每种AILD均伴有其特征性的自身抗体,对各种类型的慢性肝病常规进行自身抗体检测对于诊断和鉴别AILD有重要的临床意义。     

CMIA法测定血清DCP与AFP对肝细胞癌的诊断价值

目的 分析治疗前血清异常凝血酶原(DCP)和甲胎蛋白(AFP)在肝细胞癌(HCC)中的鉴别诊断价值。方法 采用微粒子化学发光免疫分析法(CMIA)测定2017年6月～2018年4月南通市第三人民医院住院的HBV感染相关的HCC患者110例(HCC组)、肝硬化(LC组)54例和慢性乙型肝炎(CHB组)63例治疗前血清DCP和AFP水平。两两比较采用Mann-Whitney U检验,多组比较采用Kruskal-Wallis H检验,率的比较采用χ²检验,Spearman秩相关分析DCP与AFP相关性,分析DCP和AFP诊断HCC受试者工作曲线下面积(ROC-AUC)、灵敏度及特异度。结果 HCC组DCP和AFP水平均显著高于LC组和CHB组(Z=-8.75,-4.89,-9.24和-5.37,均P<0.001)。DCP与AFP水平在LC组与CHB组间差异均无统计学意义(Z=-0.558,-0.077; P=0.577,0.939)。当对照组分别设为LC+CHB及LC组时,DCP诊断HCC的ROC-AUC均显著大于AFP(0.922 vs 0.741,Z=4.56; 0.921 vs 0.735,Z=4.15,均P<0.001)。当对照组设为LC+CHB时,DCP诊断HCC的敏感度和特异度均显著高于AFP(88.18% vs 58.18%,χ²=25.22; 92.31% vs 75.21%,χ²=12.57,均P<0.001)。DCP/AFP方案不能提高诊断HCC的敏感度(χ²=1.98,P=0.159)。DCP+AFP方案对诊断HCC的特异度有所提高(P=0.019)。当对照组设为LC组时,DCP诊断HCC的特异度显著高于AFP(94.17% vs 72.22%,χ²=4.79,P<0.05)。DCP与AFP具有弱相关性(r=0.367)。DCP与肿瘤大小呈正相关(r=0.633)。结论 DCP与AFP相比有较高的敏感度和特异度,两者联合检测能够提高HCC患者的检出率。