摘要
目的探讨乙型肝炎后肝硬化患者血清中自身抗体存在的情况及其对肝功能的影响。方法利用间接免疫荧光法及免疫印迹法分别检测89例乙型肝炎后肝硬化(HBC)患者及64例慢性肝炎患者(CHB)血清中自身抗体阳性率,将两组阳性率进行统计比较。将89例HBC患者按照自身抗体存在情况分成自身抗体阳性组和自身抗体阴性组,利用全自动生化分析仪分别检测两组患者的肝功指标,并与90例正常对照者(正常对照组)进行比较。结果乙型肝炎后肝硬化组自身抗体检出情况与慢性乙型肝炎组相比,AMA、AMA-M2升高最为明显(P<0.01),ANA检出率也显著增高(P<0.05),其他指标差异无统计学意义(P>0.05)。肝功能指标中,自身抗体阳性组与阴性组比较,ALP升高最为明显(P<0.01),AST、TBA值显著升高(P<0.05),其他指标差异无统计学意义(P>0.05)。自身抗体阳性组与正常对照组比较,ALT、AST、TBil、DBil、GGT、ALP、TBA值均显著升高(P<0.01)。自身抗体阴性组与正常对照组比较,ALT、AST、TBil、GGT、TBA及DBil显著升高(P<0.01或P<0.05),ALP值差异无统计学意义(P>0.05)。结论乙型肝炎后肝硬化患者合并自身免疫性肝病对肝脏损害更大,在肝病患者中检测自身抗体将有助于判断肝病患者病情的严重程度和预后。
Objective To explore subsistent situation of serum autoantibodies in patients with hepatic B cirrhosis （HBC） and the influence on the hepatic function. Methods Use indirect immunofluorescence assay and imrnunoblottest respectively to detect the autoantibodies in the serum of 89 patients with HBC and 64 patients with chronic hepati- tis B （CHB）. Compare with the two sets of positive quantity and according to their subsistent situation of autoantibod- ies divide the 89 CHB patients into two groups （autoantibody positive group and autoarrtibody -negative group）. Use the automatic biochemical analyzer respectively to detect the two groups of patients with the indexes of hepatic func- tion,and then compared with the 90 cases of normal controls. Results Compared with the CHB group,the positive rate of AMA,AMA-M2 of HBC group has the most significant increase（P〈0. 01）, another improvement is ANA （P〈 0.05）. The difference of other autoantibody-indicators was not statistically significant（P〉0.05）. As the result of the comparison on hepatic function index between autoantibody-positive group and autoantibody-negative group, the most significant increase is ALP （P〈0.01） ,AST,TBA was the second significantly improvement（P〈0.05） ,and the differ- ence of other indicators was not statistically significant（P〉0.05）. ALT, AST, TBil, DBil, GGT, ALP, TBA were all in- creased significantly（P〈0.01）, when autoantibody-positive group compared with the normal control group. ALT, AST TBil, GGT, TBA and DBil of autoantibody-negative group are all significant higher than the normal control group （P〈 0.01 or P〈0.05） ,while the difference of ALP was not significant （P〉0.05）. Conclusion Patients With HBC will ag- gravate liver damage after complicating autoimmune liver disease. Therefore,the detection of autoantibodies in patients with liver disease will help to judge not only the severity of the hepatic patient＇s condition but also the prognosis.
出处
《中国实验诊断学》
2013年第11期2022-2025,共4页
Chinese Journal of Laboratory Diagnosis
