原发性胆汁性肝硬化特异性自身抗体的筛查和分析

目的 调查原发性胆汁性肝硬化(PBC)特异性自身抗体抗线粒体抗体(AMA)M2型、抗gp21t0和抗sp100在普通成人中的流行情况,并初步调查PBC的患病率.方法 以间接免疫荧光法初筛8126名体检者血清抗核抗体(ANA)及AMA,再用酶联免疫吸附法或Western blot检测ANA或AMA阳性血清中AMA-M2、抗sol00和抗gp210,最后结合临床表现和其他检查结果进行诊断.结果 8126名成年人中AMA阳性35例(0.43%,95%可信区间为0.30%～0.58%)、ANA79例(0.97%),两种抗体阳性率均随年龄的增长而增高.PBC特异性自身抗体阳性共22例,其中19例为AMA-M2阳性(0.23%),抗sp100阳性4例(0.05%),抗gp210阳性3例(0.04%).在PBC发病集中的40岁以上妇女中,PBC特异性自身抗体检出率为0.62%.22名PBC特异性自身抗体阳性者中只有1名女性最终被确诊为PBC.结论 PBC特异性自身抗体在普通成人中均较为少见,我国南方地区成人PBC患病率可能并不低于其他地区.

Frequencies of autoantibodies specific for primary biliary cirrhosis in a general adult population group

Objectives To investigate the frequencies of primary biliary cirrhosis (PBC)-specific autoantibodies, including antimitoeondrial autoantibodies (AMA) M2, anti-gp210 and anti-Sp 100, and to assess their point prevalence rates in a general adult population group in Guangzhou. Methods Eight thousand one hundred twenty-six adults (mean age 43.5 + 14.6 years, range 18 to 83 years; 4248 males and 3878 females) were enrolled for this study. AMA and anti-nuclear antibodies (ANA) were screened by indi-rect immunofluorenscence test and AMA-M2, anti-gp210 and anti-sp 100 were further detected using ELISA or immunoblotting assay. PBC diagnosis was made according to criteria recommended by AASLD in 2000. Results Of the 8126 adults tested, 35 (0A3%) and 79 (0.97%) were found to be positive for AMA and ANA. The positivity for both of AMA and ANA increased with aging. Twenty-two cases were positive for PBC-specific antoantibodies. Frequencies for AMA-M2, anti-sp 100 and anti-gp210 in the general adult population were 0.23%, 0.05% and 0.04% respectively aad their frequency reached 0.62% in women over 40 years. A woman among the 22 cases who was PBC-speeifie autoantibody positive was finally diagnosed as a PBC patient. Conclusion Our data indicates that PBC specific autoantibodies exist in the general adult popula-tion at very low frequencies and the point prevalence rate of PBC in adults in Guangzhou is not less than that of other areas.