【摘要】 目的探讨抗髓过氧化物酶(anti-myeloperoxidase,MPO)抗体检测对诊断自身免疫性肝炎(autoimmune hepati-tis,AIH)的临床意义及诊断的评估方法。方法研究对象为56例AIH患者、176例非AIH及40例健康体检者,采用ELISA法检测抗MPO抗体和间接免疫荧光法(IIF)检测抗核抗体(anti-nuclear antibodies,ANA)、抗平滑肌抗体(smoothmuscle antibod-ies,SMA)和抗中性粒细胞胞质抗体(anti-neutrophil cytoplasmic antibodies,ANCA)等自身抗体并观察其临床评估指标,对其结果进行回顾性分析。结果1)56例AIH与176例非AIH检测MPO结果显示其阳性率分别为64.3%(36/56)和1.7%(3/176);组间比较,P<0.01差异有非常显著性意义。2)AIH及非AIH各疾病检测结果为SMA抗体阳性率最高为69.6%(39/56),MPO、ANCA和SMA抗体检测在AIH与PBC中,经χ2检验,P<0.01差异均有非常显著性意义。3)AIH患者的临床评价指标在患病率不改变的情况下,结果显示除阴性似然比外最高均为SMA;阴性似然比ANCA最高为1.25。4)AIH-I患者检测MPO抗体的结果阳性率为87.2%(34/39);AIH-Ⅱ患者无1例阳性;AIH-Ⅲ患者2例阳性。表明AIH-I患者与其密切相关。5)AIH-I患者的临床评价指标在患病率不改变的情况下,结果显示除阴性似然比外亦是SMA最高;阴性似然比ANCA最高为0.19。结论血清抗髓过氧化物酶抗体联合其他自身抗体的检测对诊断、治疗和阻止AIH的发展有着十分重要作用。对提高AIH在临床上同其它肝病鉴别诊断和治疗有着非常重要的意义。更多还原

【Abstract】 Objective To explore the clinical value of anti-myeloperoxidase (MPO) antibody detection in the diagnosis of autoimmune hepatitis (AIH). Methods In 56 cases of AIH,176 patients of non-AIH,and 40 healthy persons,enzyme-linked immunosorbent assay (ELISA) was used to detect MPO,and indirect immunofluorescence (IIF) was used to detect anti-nuclear antibodies (ANA),smooth muscle antibodies (SMA),and anti-neutrophil cytoplasmic antibodies (ANCA). The result was retrospectively analyzed. Results The positive rate of MPO (64.3%,36/56) in 56 cases with AIH was significantly higher than that (1.7%,3/176) in non-AIH patients (P<0.01). The positive rate of SMA was the highest in AIH patients (69.6%,39/56),as compared with ANA,SMA,and ANCA positive rates. After chi-square test,the positive rates of MPO,ANCA,and SMA were markedly different between AIH and primary biliary cirrhosis (PBC) patients (P<0.01). As the same prevalence of AIH,SMA was the highest in all of the clinical markers except the negative likelihood ratio. And the highest negative likelihood ratio was 1.25 to ANCA. The positive rate of MPO was 87.2% (34/39) in AIH-Ⅰ cases. None was positive in AIH-Ⅱ,while 2 positive cases found in AIH-Ⅲ. As the same prevalence of AIH-Ⅰ,SMA was the highest in all of the clinical markers except the negative likelihood ratio. And the highest negative likelihood ratio was 0.19 to ANCA. Conclusion Detection of MPO and other autoantibodies in serum is very helpful in the diagnosis and therapy of AIH.更多还原