自身抗体检测在自身免疫性肝病诊断中的应用

目的:了解自身免疫性肝病患者可能出现的各种自身抗体阳性率,以提高对该病的认识。方法:分别应用间接免疫荧光法和欧蒙斑点法检测92例自身免疫性肝病患者和30例健康人的ANA、SMA、AMA、AMA-M2,抗LKM-1、抗SLA/LP。92例患者分为四组:自身免疫性肝炎27例,原发性胆汁性肝硬化29例;原发性硬化性胆管炎6例;不明原因肝损伤30例。结果:自身免疫性肝炎组ANA、SMA、抗LKM-1、抗SLA/LP的阳性率分别为81.5%、51.9%、11.1%、18.5%。原发性胆汁性肝硬化组ANA、AMA、AMA-M2阳性率为89.7%、93.1%、89.7%,原发性硬化性胆管炎组检测ANA1例(16.7%),不明原因肝损伤ANA9例(30%),AMA3例(10%)。结论:多数自身免疫性肝病伴有特异性自身抗体的出现;自身抗体的检测对临床肝病学具有重要的意义。

Application of Detecting Autoantibodies in the Diagnosis of Autoimmune Liver Disease

Objective To know the positive rates of various autoantibodies probably existing in patients with autoimmune liver disease and to improve its recognition. Methods 92 patients were divided into four groups, among them 27 patients with autoimmune hepatitis, 29 patients with primary biliary cirrhosis, 6 patients with primary sclerosing cholangitis, 30 patients with obscure liver injury. 92 patients with autoimmune liver disease and 30 healthy people were respectively detected by indirect immunefluorescence and immuoblot assay about antinuclear antibodies （ANA）, antismooth muscle antibodies （SMA）, antimitochondrial antibodies （AMA）, subtype of AMA （M2）, anti-liver-kidney microsomal antibody type 1（LKM-1） and soluble liver antigen/liver pancreas （SLA/LP）. I=losuIts Positive rates ofANA, SMA, LKM-1 and SLA/LP were respectively 81.5% ,51.9%, 11.1%, 18.5% in autoimmune hepatitis. ANA,AMA,AMA-M2 respectively showed positive rates of 89.7% ,93.1% ,89.7% in primary biliary cirrhosis. Positive ANA was detected in lcase with primary sclerosing cholangitis （16.7%）. ANA and AMA were respectively detected 9 cases （30%）and 3 cases （ 10%）in unclear liver disease. Conclusion The majority of autoimmune liver diseases were accompanied with specific autoantibodies. The detection of autoantibodies is important in clinical hepatology.