抗线粒体抗体及其分型对原发性胆汁性肝硬化的诊断价值

目的 研究抗线粒体抗体(AMA)及其分型检测对原发性胆汁性肝硬化(PBC)的诊断价值。 方法 应用间接免疫荧光法测定血清中AMA抗体,用免疫印迹法检测AMA-M2、M4、M9亚型。78例PBC患者、35例其他肝病患者和20名健康体检者检测AMA及M2,其中30例PBC患者检测M4、M9亚型。 结果 78例PBC患者中74例(94.9％)AMA及M2均阳性,1例AMA阳性而M2阴性,3例AMA及M2均阴性。35例其他肝病患者M2均阴性,2例AMA阳性,1例AMA弱阳性。30例M2均阳性PBC患者中,16例M4阳性(53.3％),4例M9阳性(13.3％)。20名健康体检者AMA及M2均阴性。 结论 AMA及其分型,特别是M2抗体检测可作为临床诊断PBC的重要血清免疫学指标。

The value of antimitochondrial antibody and its subtypes in the diagnosis of primary biliary cirrhosis

Objective A study on the value of antimitochondrial antibody (AMA) and its subtypes anti-M2, anti-M4, and anti-M9 in diagnosing primary biliary cirrhosis (PBC). Methods Antimitochondrial antibody was detected by indirect immunofluorescence and anti-M2, anti-M4 and anti-M9 by Western blotting. AMA and anti-M2 of 78 PBC patients, of 35 non-PBC hepato-biliary disease patients and 20 healthy controls were studied and anti-M2, anti-M4 and anti-M9 were studied in 30 of the 78 PBC patients. Results 96.2% (75/78) of PBC patients were AMA positive and 94.9% (74/78) of PBC patients were anti-M2 positive. Only three among the 35 non-PBC patients were positive for AMA (one with very low titre). None of the 35 non-PBC patients was anti-M2 positive. AMA and anti-M2 were negative in all the healthy controls. Among the 30 anti-M2 positive patients, 16 patients were anti-M4 positive (16/30, 53.3%) and 4 patients were anti-M9 positive (4/30, 13.3%). Conclusion AMA and its subtypes (special anti-M2) are important sero-immunological markers for the diagnosis of PBC.