自身免疫性肝炎与丙型肝炎患者自身抗体特征分析

目的探讨自身免疫性肝炎（AIH）与丙型肝炎患者血清中自身抗体的特征，相关性及诊断应用价值。方法间接免疫荧光法，免疫印迹法检测自身免疫性肝炎、丙型肝炎患者血清中出现的ANA、ASMA、AMA及抗SIA／LP、抗LKM-1和抗LC-1等肝脏疾病相关的自身抗体。结果AIH患者自身抗体主要以ANA、ASMA抗体为主，其中抗体合并阳性率占53．3％，而丙型肝炎患者仅占3．6％，此外尚有16．6％和3．3％的AIH患者出现抗SLA／LP和抗LC-1抗体，丙型肝炎患者未检测出。在抗体滴度检测中两种疾病存在极大差异（P〈0．01），AIH患者以高滴度抗体为主，抗体滴度常在1：160（64．0％），丙型肝炎患者在1：100以内（66．6％）以低滴度抗体为主。有5例（6．1％）丙型肝炎患者出现与AIH相似的自身抗体抗LKM-1抗体，其中有2例抗体滴度大于1：100，进行肝穿病理检测提示符合Ⅱ型AIH。结论MH和丙型肝炎患者在感染过程中，免疫介导和病毒对肝细胞都有直接损伤，但在感染病例中如何选择治疗方案成为关键，监测自身抗体滴度对提高诊断调整治疗方案将有着重要意义。

Analyzing of auto-antibodies in autoimmune and C virus hepatic diseases

Objective Study for characteristics and diagnostic value of auto-antibodies in autoimmune and C virus hepatic disease. Methods ANA,ASMA,AMA,anti-SIA/LP, anti-LKM-1 and anti-LC-1 in serum of patients with autoimmune hepatic disease （AIH）and with C virus hepatic disease were tested by IIF and WB.Results ANA and ASMA were the main auto-antibodies in autoimmune hepatic（AIH） disease and the positive rate was 53.3% ,compared with that of 3.6% in patients of C virus hepatic disease. Anti-SLA/LP and anti-LC-1 in AIH was16.6% and 13.3% respectively,but were not tested in C virus hepatic disease. The titer of auto-antibodies in AIH（ 1 ： 160 in 64.0% ） was significantly higher than that in C virus hepatic disease（ ≤ 1 ： 100 in 66.6% ）. Anti- LKM-1 was detected in 5 cases（6.1% ） of C virus hepatic disease, the titer was ≥ 1 ： 100 in 2 cases and the reaults of hepatic puncture corresponded with type of AIH. Conclusion Hepatic damages dependent on immune and virus factors in AIH and C virus hepatic disease. Monitoring of auto-antibodies titer was clinically significant for selecting therapeutic plans.