摘要
目的:原发性胆汁性肝硬化(PBC)与自身免疫性肝炎(AIH)的临床表现存在相似性,因而不易鉴别及诊断。本研究对免疫球蛋白在PBC和AIH中的表达情况进行比较并分析其意义,为两种疾病的鉴别和诊断积累临床资料。方法:选取2011年10月-2012年10月在我院接受治疗的原发性胆汁性肝硬化患者20例作为PBC组,另选取20例同期入院治疗的自身免疫性肝炎患者作为AIH组。利用免疫组化法检测两组患者病变组织中免疫球蛋白IgM和IgG的表达水平,比较两组细胞的阳性表达率,并对阳性细胞含量进行评分。结果:PBC组:17例患者显示IgM阳性(85%),3例患者显示IgG阳性(15%),IgM与IgG比值>1,IgM评分为3.2±0.8,IgG评分为1.5±0.6;AIH组:18例患者显示IgG阳性(90%),2例患者显示IgM阳性(10%),IgM与IgG比值<1,IgM评分为1.2±0.7,IgG评分为2.4±0.9。PBC组的IgM评分明显高于AIH组,而AIH组的IgG评分则明显高于PBC组,差异具有统计学意义(P<0.05)。结论:检测IgG和IgM的表达水平对原发性胆汁性肝硬化与自身免疫性肝炎的临床诊断具有较高的敏感性和特异性,可作为鉴别两种疾病的依据之一,值得进一步推广应用。
Objective： It is difficult to identify and diagnose the primary biliary cirrhosis（PBC） and the autoimmune hepatitis（AIH） for the similarities of their symptoms. This article is written to provide a reference for clinical diagnosis by means of detecting the phenotypes of the immunoglobulin in liver tissues of PBC and AIH. Methods： 20 patients with primary biliary cirrhosis who were treated in our hospital from October 2011 to 2012 were selected as the PBC group, and another 20 patients with autoimmune hepatitis simultaneously were chosen to be the AIH group. Then the positive rates of IgM and IgG were detected by the immunohistochemistry, the levels of the plasma cells were compared and the concentrations of positive cells were evaluated in the two groups. Results： In the PBC group, there were 17 cases positive in IgM（85%）, 3 in IgG（15%）, IgM/IgG〉1; The IgM score was 3.2±0.8 and the IgG score was 1.5±0.6. In the AIH group, there were 18 cases positive in IgG（90%）, 2 in IgM（10%）, IgM/IgG〈1; The IgM score was 1.2±0.7 and the IgG score was 2.4±0.9. The IgM score of the PBC group was higher than that of the AIH group, while the IgG score of the AIH group was higher than that of the PBC group with statistically significant differences（P〈0.05）. Conclusions： It is indicated that the detection of the expressions of IgG and IgM should be well promoted to the clinical as a guidance with the higher sensitivity and specificity of distinguishing the PBC and AIH.
出处
《现代生物医学进展》
CAS
2014年第13期2450-2452,共3页
Progress in Modern Biomedicine
基金
国家自然科学基金青年科学基金项目(30901795)
