原发性胆汁性肝硬化患者抗gp210抗体与核膜型抗核抗体的检测及其临床意义

目的探讨抗gp210抗体与核膜型抗核抗体对原发性胆汁性肝硬化(PBC)患者的诊断意义。方法选取PBC患者100例,60例自身免疫性肝炎(AIH)患者、50例慢性乙型肝炎(HBV)患者和50例慢性丙型肝炎(HCV)患者作为疾病对照组,50例献血员(BD)作为正常对照组。间接免疫荧光法检测自身抗体,免疫印记法检测抗gp210抗体。结果间接免疫荧光法检测结果 ,抗核抗体(ANA)阳性60例,抗线粒体抗体(AMA)阳性100例,抗平滑肌抗体(SMA)阳性3例。免疫印记法检测PBC患者抗gp210阳性33例(阳性率33%),AIH患者抗gp210阳性8例(阳性率13%),HBV、HCV、BD组均阴性。PBC患者gp210阳性组与阴性组ANA滴度比较,差异无统计学意义;gp210阳性组90.9%表现核膜型,其次表现核点型,而gp210阴性组19.4%表现核点型,其次为着丝点型及核膜型等。PBC患者抗gp210阳性患者与阴性患者ALT、AST、Tbil、GGT、ALPI、gGI、gAI、gM水平差异均无统计学意义(P0.05)。gp210阳性患者肝硬化发生率(28/33例,84.8%)明显高于阴性患者(33/67例,49.3%)(P0.01)。结论抗gp210抗体阳性同时ANA为核膜型有助于PBC患者的诊断,并且抗gp210抗体可以作为预后指标。

The significance of gp210 and nuclear membrance antibodies in diagnosing primary cirrhosis

Objective To study the significance of gp210 and nuclear membrance antibodies in diagnosing primary biliary cirrhosis.Methods 100 PBC patients were studied,60 AIH cases,50 HBV cases and 50 HCV cases were chosen as a disease control.50 health blood donors were chosen as a health control.Autoantibodies were tested by immunofluorescent assay（IFA）.Gp210 antibodies were detected by EUROLINE.Results In 100 PBC patients,60 cases had ANA,3 cases had SMA.All of PBC patients were positive of AMA.For the gp210 tested,there were 33 cases of PBC positive,8 cases of AIH positive,there were no positive cases in other groups.There were no significant differences of antinuclear antibody titer between gp210 positive cases and negative.But the ANA type was different.Most of the ANA type of gp210 positive cases were nuclear membrance（90.9%）,while the ANA type of gp210 negative were nuclear dots（19.4%）.The levels of ALT、AST、Tbil、GGT、ALP、IgG、IgA、IgM in serum were no difference between gp210 positive and negative in PBC patients（P0.05）.The liver cirrhosis rates of gp210 positive patients are higher than that of negative.Conclusion The detection of gp210 and nuclear membrance antibodies has great significance to the diagnosis of primary biliary cirrhosis.And gp210 antibody may be an index to prognosis for PBC patients.