摘要
目的探讨抗着丝点抗体(ACA)的肝功异常患者中出现的频率、特点及其临床意义。方法对10000例肝功异常患者采用间接免疫荧光法检测抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(SMA)和抗细胞骨架抗体等,并采用免疫印迹法检测抗着丝点抗体及其它抗可提取的核抗原(antextractablen2uclearantigens,ENA)抗体。结果 (1)10000例肝功异常患者中,间接免疫荧光法筛选结果显示抗核抗体阳性,着丝点型的患者为134例,占1.34%。其中滴度1∶100的占35.8%;滴度1∶320的占40.3%;滴度大于等于1∶1000的占23.9%。滴度大于等于1:320的患者再免疫印迹法检测,抗着丝点抗体均为阳性。部分患者伴有其他核型的抗核抗体以及抗线粒体抗体等自身抗体。(2)134例ACA阳性患者,诊断为硬化型肝病的有83例,包括PBC、PBC和AIH重叠症、肝炎肝硬化以及原发性肝癌硬化型。诊断为非硬化型肝病的有51例,包括病毒性乙型肝炎、自身免疫性肝炎、药物性肝炎和病毒性丙型肝炎等。抗着丝点抗体高滴度组患者的肝硬化发生率明显高于低滴度组。(3)分析高滴度组(滴度大于等于1∶320)和低滴度组(滴度1∶100)组的实验室检查结果发现,ACA高滴度组AST/ALT比值明显高于低滴度组,ALB和PA明显低于低滴度组,IgM的含量也高于低滴度组,两组间的差别有统计学意义。结论肝病患者中,抗着丝点抗体并不少见,高滴度的抗着丝点抗体更见于各种原因引起的肝硬化患者。
Objective To further investigate the clinical significance of anticentromere antibodies（ACA） in patients with abnormal liver functions.Methods Autoantibodies were tested by immunofluorescent assay and western blot analysis.Clinical characteristics were compared in patients with positive ACA.Results（1）Of 10000 cases patients with abnormal liver functions,134 cases were positives for ACA tested by immunofluorescent assay.35.8% of them showed title 1∶100,40.3% showed title 1∶320 and 23.9% showed title ≥1∶1000.ACA positive patients with title ≥1∶320,ACA was detected by western blot analysis to confirm again.ACA could coexist with several pattems of antinuclear antibodies and other antibodies.（2） Anticentromere antibodies could detected in many kinds of abnormal liver functions.83 cases were dialoged sclerosing liver disease including PBC（primary billiary cirrhosis）,Hepatitis cirrhosis and so on.51 cases were dialoged nonsclerosing liver disease including chronic viral hepatitis,alcoholic haptitis,drug-induced liver disease,AIH and so on.Higher title ACA was positively associated with liver cirrhosis.（3） According ACA title,patients were separated into two groups：low title group and high title group.But AST/ALT value and IgM in high title group was distinguished higher than value in low title group,and ALB and PA were in high title group was significantly lower than that in low title group.Conclusion Anticentromere antibody was found in patients with abnormal liver functions,Higher title ACA was positively associated with liver cirrhosis.
出处
《中国实验诊断学》
2012年第4期666-668,共3页
Chinese Journal of Laboratory Diagnosis
基金
北京市自然科学基金项目(7111004)
关键词
自身抗体
着丝点
肝硬化
Anticentromere antibody
Liver cirrhosis
