肝病相关抗体的检测及临床应用

Detection of autoantibodies in liver diseases and its clinical application

关键词:  自身免疫性肝病  自身抗体  间接免疫荧光法  免疫印迹法

Key words:  autoimmune liver disease  autoantibody  indirect immunofluorescence(IIF)  western blot

摘要:

［目的］探讨肝病相关抗体在肝脏疾病中的应用价值。［方法］ 选取乙型肝炎病毒(HBV)感染者（HBsAg、抗HBc阳性）53例;丙型肝炎病毒(HCV)感染者（抗HCV阳性）83例;不明原因肝功能异常者（各类肝炎病毒感染指标均阴性，但ALT或AST升高>40IU/L）86例，同时选择健康体检者60例作为对照组。采用间接免疫荧光法（IIF）检测各组抗核抗体（ANA）、抗平滑肌抗体（SMA）、抗线粒体抗体(AMA)；采用免疫印迹法检测抗可溶性肝抗原/肝胰抗原（SLA/LP）抗体、抗肝肾微粒体抗体I型（LKM-1）、抗肝细胞浆抗体1型（LC-1）、抗线粒体抗体Ⅱ型（AMA-M2），并分析各组阳性率。［结果］ 在间接免疫荧光法检测中,ANA、AMA、SMA的阳性率分别为正常对照组6.7%、0.0%、0.0%；乙型肝炎组39.6%、1.8%、3.8%；丙型肝炎组，53.0%、15.7%、20.5%；不明原因肝功异常组，53.5%、12.8%、17.4%。经χ²检验除乙型肝炎组的AMA和SMA外，其他各病例组3项抗体阳性率均与正常对照组有显著性差异（P<0.01）。在免疫印迹法检测中，抗可溶性肝抗原/肝胰抗原（SLA/LP）抗体阳性1例，抗肝肾微粒体抗体（LKM-1）3例，抗肝细胞浆抗体1型（LC-1）1例，抗线粒体抗体Ⅱ型（AMA-M2）5例。［结论］ 肝病相关抗体的检测在慢性肝病的诊断和鉴别诊断中有重要的临床意义。

Abstract:

［Objective］ To investigate the clinical value of several autoantibodies in autoimmune liver diseases. ［Methods］ Fifty three patients with chronic hepatitis B(HBV), 83 patients with chronic hepatitis C(HCV), 86 patients with elevated liver enzymes were studied, and 60 healthy subjects were studied as controls. Antinuclear antibodies (ANA)、antimitochondrial antibody(AMA) and anti-smooth muscle antibody (SMA) were tested by indirect immunofluorescence(IIF); Antibodies to soluble liver antigen/liver pancreas (SLA/LP)、liver kidney microsomal type 1(LKM-1)、liver cytosol type 1(LC-1) and mitochondrial type Ⅱ(AMA-M2) were tested by EUROLINE Western blot. The results were compared. ［Results］ The positive rates of ANA、AMA、SMA in HBV group were 39.6%、1.8%、3.8% respectively;that in HCV group were 53.0%、15.7%、20.5% respectively;that in patients with elevated liver enzymes were 53.5%、12.8%、17.4% respectively. All of them were compared with healthy controls which the positive rates of ANA、AMA、SMA were 6.7%、0.0%、0.0% respectively in x2 test, significant differences were found except AMA and SMA in HBV group(P<0.01). Among 222 patients, SLA/LP was positive in 1 patient and LKM-1 in 3 patients and LC-1 in 1 patient and AMA-M2 in 5 patients. ［Conclusions］ The serial autoantibodies associated with autoimmune liver diseases have an important significant in clinical diagnosis and differential diagnosis.