抗AMA-M2抗体、抗GP210抗体与原发性胆汁性胆管炎患者临床症状及相关检测指标的关系

目的探讨原发性胆汁性胆管炎(PBC)患者临床症状及相关检测指标与抗AMA-M2抗体、抗GP210抗体的关系。方法选择2014年1月至2019年12月在江苏省苏北人民医院肝脾内科住院的患者中符合2018年美国肝病协会推荐的PBC诊断标准的72例患者,根据患者血清是否含抗AMA-M2抗体分为抗AMA-M2抗体阴性组(17例)和抗AMA-M2抗体阳性组(55例);根据患者血清是否含抗GP210抗体分为抗GP210抗体阳性组(24例)和抗GP210抗体阴性组(48例)。对各临床症状和检测指标在抗AMA-M2抗体和抗GP210抗体阴性组和阳性组中的表达差异进行统计分析。结果抗AMA-M2抗体、抗GP210抗体阴性组与阳性组的各种临床症状差异无统计学意义(P>0.05)。抗AMA-M2抗体阴性组患者血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、线粒体型天门冬氨酸氨基转移酶同工酶水平均高于抗AMA-M2抗体阳性组,差异均有统计学意义(P<0.05)。PBC患者在抗核抗体(ANA)滴度为1∶320~1∶160时所占比例较高,且抗ANA抗体高滴度(>1∶80)的比例为95.83%。抗AMA-M2抗体阴性组的抗nRNP/Sm抗体阳性率较抗AMA-M2抗体阳性组高(11.76%vs.0.00%)。抗GP210抗体阳性组患者血清清蛋白/球蛋白、视黄醇结合蛋白水平较抗GP210抗体阴性组低,差异有统计学意义(P<0.05);抗GP210抗体阳性组的球蛋白水平较抗GP210抗体阴性组高,差异有统计学意义(P<0.05)。结论抗AMA-M2抗体阴性的PBC患者血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、线粒体型天门冬氨酸氨基转移酶同工酶水平均高于抗AMA-M2抗体阳性的PBC患者,抗GP210抗体阳性的PBC患者的血清清蛋白/球蛋白和视黄醇结合蛋白水平较抗GP210抗体阴性的PBC患者低,球蛋白水平较抗GP210抗体阴性的PBC患者高,表明抗AMA-M2抗体阴性及抗GP210抗体阳性的PBC患者肝脏受损比较严重。

Relationship between anti AMA-M2 antibody,anti GP210 antibody and clinical symptoms and related detection indexes in patients with primary biliary cholangitis

Objective To investigate the relationship between the clinical symptoms and related detection indexes of patients with primary biliary cholangitis(PBC)and anti AMA-M2 antibody,anti GP210 antibody.Methods The 72 patients who met the PBC diagnostic criteria recommended by the American Society of Liver Diseases in 2018 among the inpatients of the Department of Hepatosplenic Medicine in Jiangsu Subei People′s Hospital from January 2014 to December 2019 were selected as the research objects.Patients were divided into anti AMA-M2 antibody negative group(17 cases)and anti AMA-M2 antibody positive group(55 cases)according to whether the patients′serum contained anti AMA-M2 antibodies;patients were divided into anti GP210 antibody negative group(17 cases)and anti GP210 antibody positive group(55 cases)according to whether the patients′serum contained anti GP210 antibodies.The expression differences of clinical symptoms and detection indexes in anti AMA-M2 antibody,anti GP210 antibody negative group and positive group were statistically analyzed.Results There was no significant difference in the clinical symptoms between the anti AMA-M2 antibody negative group and the anti GP210 antibody positive group(P>0.05).The serum alanine aminotransferase,aspartate aminotransferase and mAST isoenzymes of the anti AMA-M2 antibody negative group were higher than those of the anti AMA-M2 antibody positive group,the difference was statistically significant(P<0.05).The proportion of anti nuclear antibody(ANA)titer of 1∶320-1∶160 was higher in PBC patients,and the proportion of high ANA titer(>1∶80)was 95.83%.The anti AMA-M2 antibody negative group had a higher anti-nRNP/Sm antibody positive rate than the anti AMA-M2 antibody positive group(11.76%vs.0.00%).The albumin/globulin and retinol binding protein of the anti GP210 antibody positive group were lower than those of the anti GP210 antibody negative group(P<0.05);the globulin in the anti GP210 antibody positive group was higher than that in the anti GP210 antibody negative group,the difference was statistically significant(P<0.05).Conclusion The alanine aminotransferase,aspartate aminotransferase,and mAST isoenzymes of PBC patients with negative anti AMA-M2 antibodies are higher than those of PBC patients with positive anti AMA-M2 antibodies.The levels of albumin/globulin and retinol binding protein in patients with positive anti GP210 antibody are lower than those in patients with negative anti GP210 antibody,globulin is higher than that of PBC patients with negative anti GP210 antibodies.It shows that PBC patients with negative anti AMA-M2 antibodies and positive anti GP210 antibodies have more severe liver damage.