自身抗体联合检测在原发性胆汁性肝硬化诊断中的意义

目的 探讨自身抗体联合检测在原发性胆汁性肝硬化(PBC)诊断中的意义.方法 选取本院2013年1月至2015年12月收治的291例肝病患者作为本组研究的研究样本,根据患者疾病类型将其分为PBC组(98例)、自身免疫性肝炎组(AIH组,91例)和其他肝病组(LDC组,102例).采用间接免疫荧光法(IIF)测定抗线粒体抗体M2亚型抗体(AMA-M2),采用ELISA法测定抗SP100以及抗-GP210抗体;结合PBC的诊断标准对自身抗体联合检测的临床诊断价值进行分析.结果 PBC组抗-Sp100以及抗-GP210的阳性率分别为28.57％(28/98)和43.87％(43/98),抗-GP210、抗-Sp100两者同时出现的阳性率为9.18％(9/98);AIH组与LDC组均末出现抗-Sp100阳性或抗-GP210阳性病例.PBC组的AMA-M2阳性率为96.94％(95/98),其中AMA-M2抗体滴度水平≥1∶800的患者39例(39.80％,39/98),AMA-M2抗体滴度水平在1∶25～1∶200的患者24例(24.49％,24/98),AMA-M2抗体滴度水平在1∶200～1∶800的患者32例(32.65％,32/98).AIH组的AMA-M2阳性率为5.49％(5/91),且所有阳性患者AMA-M2抗体滴度水平均在1∶25～1∶200内,明显低于PBC组,差异有统计学意义(P＜0.01).结论 AMA对PBC的诊断具有标志性意义,抗SP100对PBC的疾病进展具有提示作用,抗-GP210对阴性PBC患者具有诊断作用.

Combined detection of autoantibodies in diagnosis of primary biliary cirrhosis

Objective To explore the significance of the combined detection of autoantibodies in the diagnosis of primary biliary cirrhosis (PBC).Methods 291 patients with liver diseases treated at our hospital from January,2013 to December,2015 were selected as study objects and were divided into a PBC group (98 cases),an autoimmune hepatitis group (AIH group,91 cases) and an other liver diseases group (LDC group,102 cases) according to the disease types.The anti-mitochondrial antibody M2 subtype antibody (AMA-M2) was determined by IIF and anti-SP100 and anti-GP210 antibodies by ELISA.The value of the combined detection of autoantibodies in the diagnosis of PBC was analyzed according to clinical diagnostic criteria.Results The positive rates of anti-Sp100 and anti-GP210 were 28.57％ (28/98) and 43.87％ (43/98) and the positive rate of anti-GP210 and anti-SP100 was 9.18％ (9/98) in the PBC group.No one was positive in anti-Sp100 and antiGP210 in the AIH group and the LDC group.The positive rate of AMA-M2 was 96.94％ (95/98) in the PBC group;in which,39 (39.80％,39/98) patients' AMA-M2 antibody titers ≥ 1∶ 800;24 (24.49％,24/98) cases'AMA-M2 antibody titers was from 1∶ 25 to 1∶ 200,and 32 (32.65％,32/98) cases' AMA-M2 antibody titers was from 1∶200 to 1∶ 800.The positive rate of AMA-M2 was 5.49％ (5/91) in the AIH group,and all patients' AMA-M2 antibody titer was from 1∶ 25 to 1∶ 200,with was significantly lower than that in the PBC group,with a statistical difference (P ＜ 0.01).Conclusion AMA has important significance in the diagnosis of PBC.AntiSP100 can indicate the progression of PBC.Anti-GP210 can diagnose negative PBC patients.