自身免疫性肝炎自身抗体联合检测的临床意义

目的探讨多种自身抗体联合检测在自身免疫性肝炎（AIH）中的临床意义。方法收集1593例肝功能异常患者，检测抗线粒体抗体（AMA）、抗可溶性肝抗原，肝胰抗原（SLA／LP）抗体、抗肝肾微粒体（LKM-1）抗体、抗肝细胞溶质抗原1型（LC-1）抗体、抗核包膜糖蛋白（gp）210抗体、抗sp100抗体、抗平滑肌抗体（ASMA）、抗核抗体（ANA）、抗可溶性抗原抗体（ENA）谱、抗中性粒细胞胞质抗体（ANCA），并结合临床表现进行分析。结果33例诊断为AIH，ANA阳性率81．8％（27／33）；ASMA敏感度57．6％（19／33），特异度97．6％（161／165）；抗SLMLP抗体敏感度6．1％（2／33），特异度99．4％（164／165）；抗LKM-1抗体敏感度12．1％（4／33），特异度91．5％（151／165）；抗LC-1抗体敏感度9．1％（3／33），特异度99．4％（164／165）；在AIH中未发现gp210抗体、抗sp100抗体。结论联合自身抗体检测极大地提高了AIH的诊断率。

The combined detection and clinical significance of autoantibodies in patients with autoimmune hepatitis

Objective To investigate the combined detection and clinical significance of autoantibodies in patients with autoimmune hepatitis （AIH）. Methods Collected 1 593 cases of patients with hepatic dysfunction, 33 cases were diagnosed as AIH. Serum anti-smooth muscle antibody （ASMA）, soluble liver antigen/liver pancreas （SLA/LP） antibody, liver kidney mierosomal -1 （LKM-1） antibody, hepatic cell solute antigen type-1 （LC-1） antibody, anti-mitochondrial antibody （AMA）, antinuclear envelope glycoprotein （ gp ） 210 antibody, anti sp 100 antibody, antinuclear antibody （ ANA ）, anti ex- tractable nuclear antigen antibody spectrum （ENA） and anti neutrophil cytoplasmic antibody （ANCA） were measured in patients. The clinical manifestations were recorded. Results In 33 patients with AIH, the positive rate of ANA was 81.8% （27/33）. For the diagnosis of AIH, the sensitivity/specificity rate of ASMA were 57.6%（19/33）/97.6%（161/165）. The sensitivity/specificity rate of LKM-1 antibody were 12.1%（4/33） /91.5 % （ 151 / 165 ）. The sensitivity/specificity rate of SLA/LP antibody were 6.1% （2/33）/99.4% （ 164/165 ）. The sensitivity/specificity rate of anti LC-1 antibody were 9.1% （3/33）/99.4% （164/165）. There were no anti- sp100 antibody and anti-gp210 antibody in AIH. Conclusion The diagnostic rate of AIH is improved by combined detection of autoantibodies.