【摘要】 目的探讨多种自身抗体联合检测在原发性胆汁性肝硬化(PBC)中的临床意义。方法检测32例PBC患者抗线粒体抗体(AMA)、可溶性肝抗原/肝胰抗原(SLA/LP)抗体、抗肝肾微粒体(LKM-1)抗体、抗肝细胞溶质抗原1型(LC-1)抗体、抗核包膜糖蛋白(gp)210抗体、抗sp100抗体、抗平滑肌抗体(ASMA)、抗核抗体(ANA)、抗可提取核抗原(ENA)抗体谱和抗中性粒细胞浆抗体(ANCA),并结合临床表现进行分析。结果 32例PBC患者中,ANA阳性率96.9%,胞浆型占83.9%。对于诊断PBC,AMA-M2的敏感性为93.8%、特异性89.8%;其中,AMA-M2(斑点法)敏感性90.0%、特异性89.7%,AMA-M2(印迹法)敏感性100%、特异性93.2%,AMA-M2(ELISA)敏感性100.0%、特异性87.7%;抗gp210抗体敏感性33.3%、特异性95.5%;抗sp100抗体敏感性20.0%、特异性97.7%。在PBC中未发现抗LKM-1抗体、抗LC-1抗体和抗SLA/LP抗体。结论联合自身抗体检测极大地提高了PBC的诊断率。更多还原

【Abstract】 Objective To investigate the clinical significance of combined determination of antibodies in patients with primary biliary cirrhosis(PBC).Methods Combined determination of antibodies was performed in 32cases with PBC,which included serum anti-mitochondrial antibody(AMA),soluble liver antigen/liver pancreas(SLA/LP)antibody,liver kidney microsomal antibody(LKM-1),hepatic cell solute antigen type-1(LC-1)antibodies,antinuclear envelope glycoprotein(gp) 210,anti-sp100antibody and anti-smooth muscle antibody(ASMA),antinuclear antibody(ANA),anti-extractable nuclear antigen antibody spectrum(ENA),anti-neutrophil cytoplasmic antibody(ANCA).The results were analyzed together with clinical manifestations.Results In 32patients with PBC,the positive rate of ANA was 96.9% and cytoplasmic type was 83.9%.For the diagnosis of PBC,the sensitivity and specificity rates of AMA-M2were 93.8% and 89.8%,respectively,in which sensitivity and specificity rates of AMA-M2measured by dot method,immunoblot and ELISA were 90%and 89.7%,100% and 93.2%,and 100% and 87.7%.In the diagnosis of PBC,the sensitivity and specificity rates of anti-gp210antibody were 33.3% and 95.5%,which of anti-Sp100antibodies were 20.0%and 97.7%.No LKM-1,anti-LC-1and anti-SLA/LP antibodies were detected in PBC.Conclusion Combined detection of autoantibodies can remarkably improve the diagnostic rate of PBC.更多还原