自身免疫性肝病与病毒性肝病患者自身抗体和肝功能的相关性研究

发布时间：2018-03-03 03:21

本文选题：自身免疫性肝病　切入点：病毒性肝病　出处：《职业与健康》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨自身免疫性肝病(ALDS)患者与病毒性肝病患者检测自身抗体与肝功能的临床价值。方法应用免疫印迹法和间接免疫荧光法检测自身免疫性肝病、病毒性肝病患者和健康检查者血清中的自身抗体,并测定每位患者的肝功能。结果 ALDS组中抗核抗体(AVA)的阳性检出率(88.2%)明显高于病毒性肝病组(15.9%),差异有统计学意义(P0.05),在检测肝病自身抗体时ALDS组中线粒体抗体(AMA)的检出率为65.7%,明显高于病毒性肝病组的0.6%(P0.01)。在肝病自身抗体中自身免疫性肝炎(AIH)的抗平滑肌抗体(SMA)阳性率为47.2%,明显高于原发性胆汁性肝硬化(PBC)组的17.1%,但PBC组的AMA阳性率为95.7%,则显著高于AIH组。AIH的ANA的核型主要为颗粒型;PBC为着丝点型;原发性硬化性胆管炎(PSC)为核膜型;病毒性肝病则未见特定荧光核型。在ALDS组与病毒性肝病组中,丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)和谷氨酰转肽酶(GGT)活力均升高,差异有统计学意义(P0.05),但免疫球蛋白(Ig G)差异无统计学意义(P0.05)。结论自身抗体对ALDS与病毒性肝病患者的诊断与鉴别有重要意义,ALDS的诊断可结合自身抗体检测与肝功能的结果以提高诊断的准确性。
[Abstract]:Objective to investigate the clinical value of autoantibodies and liver function in patients with autoimmune liver disease (ALDS) and viral liver disease. Methods Immunoblot and indirect immunofluorescence assay were used to detect autoimmune liver disease. Autoantibodies in the serum of patients with viral liver disease and health examiners, Results the positive rate of antinuclear antibody (AVA) in ALDS group was significantly higher than that in viral liver disease group (P 0.05), and the mtDNA antibody level in ALDS group was significantly higher than that in viral liver disease group (P 0.05). The positive rate of anti-smooth muscle antibody (SMA) in autoantibodies to autoimmune hepatitis of liver disease was 47.2, which was significantly higher than that in the group of primary biliary cirrhosis (PBC), but the positive rate of AMA in PBC group was higher than that in the group of primary biliary cirrhosis. The karyotype of ANA was significantly higher than that of AIH group (95.7%), and the karyotype of ANA was mainly granular type (PBC) and centromere type (P < 0.05). In ALDS group and viral liver disease group, the activities of alanine aminotransferase (alt), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase (GGT) increased. The difference was statistically significant (P 0.05), but the difference of immunoglobulin G (Ig G) was not statistically significant. Conclusion autoantibodies are of great significance in the diagnosis and differential diagnosis of ALDS and patients with viral liver disease. The diagnosis of autoantibodies can be combined with the detection of autoantibodies and liver function. To improve the accuracy of diagnosis.
【作者单位】：武汉大学人民医院检验科;
【基金】：武汉大学人民医院国家临床重点专科建设项目(财社[2010]305号)
【分类号】：R512.6;R575

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