134例自身免疫性肝病患者自身抗体的分析

目的：探讨自身免疫性肝脏疾病的自身抗体特征，以提高对该病的认识。方法：在134例患者中,原发性胆汁性肝硬化（PBC）73例，自身免疫性肝炎（AIH）43例，原发性硬化性胆管炎（PSC）4例，乙型病毒性肝炎（HBV）3例，丙型病毒性肝炎（HCV）6例，非甲-戊型病毒肝炎（Non A-E）5例。采用间接免疫荧光法、免疫印迹法等分别检测抗核抗体（ANA）、抗线粒体抗体（AMA）、抗肝肾微粒体抗体Ⅰ型（LKM-1）、抗可溶性肝抗原，肝胰抗原（SLA／LP）和AMA-M2亚型等。结果：6例LKM-1阳性，6例SLA／LP阳性，分别见于AIH、AIH／PBC重叠综合征和HCV患者。PBC患者AMA和AMA-M2阳性率为94．5％，ANA阳性率为90.4％，以胞浆型为主（32／66）。AIH患者的ANA阳性率为90．7％，以核膜型为主（19／39）。非甲～戊组，2例AMA和AMA—M2阳性，1例SMA阳性。结论：检测自身抗体有助于该病的诊断，临床不能忽视肝功能异常的患者，诊断时应考虑可能患有自身免疫性肝病。

Detection of Autoantibodies in Patients with Autoimmune Liver Disease

Objective: To study the characteristics of autoantibodies in autoimmune liver diseases and to improve its recognition. Methods: One hundred and thirty four patients were included in this study, among them 73 patients with primary biliary cirrhosis (PBC), 43 patients with autoimmune hepatitis (AIH), 4 patients with primary sclerosing cholangitis (PSC), 3 patients with hepatitis B (HBV), 6 patients with hepatitis C (HCV) and 5 patients with hepatitis non AE (Non A-E). Antinuclear antibodies (ANA),antimitochondrial antibodies (AMA),antismooth muscle antibodies (SMA) and anti-liver-kidney microsomal antibody type 1(LKM-1) were tested by indirect immunofluorescence. LKM-1, soluble liver antigen/liver pancreas (SLA/LP) and subtype of AMA (M2) were detected by Western blot analysis. Results: Positive LKM-1 and positive SLA/LP were detected in 6 cases with AIH, AIH/PBC overlap syndromes and HCV infection respectively. AMA and M2 showed a positive rate of 94.5% in PBC. ANA showed a positive rate of 90.4% with main ANA pattern of cytoplasm components(32/66). ANA were 90.7% positive in AIH patients, and its main ANA pattern was nuclear membrane(19/39). AMA and AMA-M2 were positive in 2 cases in Non A-E group. One case in NonA-E group had high titer of SMA. Conclusion: The detection of autoantibodies is helpful for the diagnosis of autoimmune liver diseases. Autoimmune liver diseases should be considered when patients with abnormal liver functions.