病毒性肝炎患者血清抗核抗体谱检测的临床意义分析

目的探讨乙型病毒感染肝炎(HBV)、丙型病毒感染肝炎(HCV)患者血清抗核抗体谱检测的临床意义，为临床诊断及疗效提供参考。 方法回顾性分析1875例HBV、563例HCV、488例体检健康者(HC)的抗核抗体谱(ANAs)阳性分布；根据病毒性肝炎患者抗核抗体谱结果情况分为阳性组和阴性组，收集并分析两组患者一般资料、肝功能指标、免疫球蛋白，纳入有完整资料的患者为456例。 结果HBV患者的ANAs阳性率为18.40%，HCV患者为11.90%，HC患者为4.10%，病毒性肝炎组与健康对照组的ANAs阳率性有显著性差异(P<0.05)。病毒性肝炎组的ANAs阳性率与HC比较有显著性差异(P<0.05)的抗体有：抗dsDNA抗体、抗Nucleosome抗体、抗Histone抗体、抗SSA/Ro60抗体、抗SSA/Ro52抗体、抗SSB抗体、抗AMA-M2抗体、抗CENP-B抗体。最常见SSA/Ro52抗体阳性；病毒性肝炎组ANAs性别比较，阳性组女性多于阴性组，差异有统计学意义(P<0.05)；病毒性肝炎患者ANAs阳性组AST、ALT、GGT、TBI均高于阴性组，白蛋白ALB水平低于阴性组，差异均有统计学意义(P<0.01)。病毒性肝炎患者ANAs阳性组IgG高于阴性组，差异均有统计学意义(P<0.01)。 结论通过检测病毒性肝病患者血清中的多项抗核抗体谱，有助于了解机体的免疫状况，对疾病的临床诊疗和转归具有一定的指导作用。

Clinical significance of serum antinuclear antibody profiling in patients with viral hepatitis

ObjectiveThe main purpose of this study was to explore clinical significance of serum antinuclear antibody (ANA) profiling in patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and to provide references for clinical diagnosis and treatment efficacy. MethodsWe retrospectively analyzed the positive rate of ANAs in 1875 cases of HBV, 563 cases of HCV, and 488 healthy controls (HC). Patients with viral hepatitis infection were divided into two subgroups according to ANA results. Demographic data, liver function indexes and immunoglobulin levels of 456 patients were completed collected and analyzed. ResultsThe ANA positive rate was 18.40% in HBV patients, 11.90% in HCV patients, and 4.10% in HC patients, and there was a significant difference in ANAs positivity between the viral hepatitis group and healthy controls (P<0.05). The antibodies that showed a significant difference (P<0.05) in the positive rate of ANAs compared with HC in the viral hepatitis group were: anti-dsDNA antibodies, anti-nucleosome antibodies, anti-histone antibodies, anti-SSA/Ro60 antibodies, anti-SSA/Ro52 antibodies, anti-SSB antibody, anti-AMA-M2 antibody, and anti-CENP-B antibody. The most frequent antibody in viral hepatitis was anti-SSA/Ro52 antibody. There were more females in patients with viral hepatitis having ANA positivity (P<0.05). AST, ALT, GGT and TBI were higher in the ANAs-positive group and albumin ALB levels were lower in the negative group, and the differences were significant (P<0.01). The IgG level was significant higher in the ANAs-positive group than in the negative group (P<0.01). ConclusionThe detection of multiple ANA profiles in the serum of viral liver disease patients helps .to understand the immune status of the organism and has a certain guiding effect on the clinical diagnosis and regression of the disease.