【摘要】 目的探讨肝病相关自身抗体与Th17、Treg细胞在自身免疫性肝炎（AIH）中的临床意义。方法选择52例AIH患者为实验组,60例乙型肝炎（CHB）患者为CHB组,及60例健康体检者作为对照组,间接免疫荧光测定ANA、ASMA,免疫印迹法检测ANAs以及肝病相关自身抗体（LKM、M2、SLA/LP、LC-1、sp100、gp210抗体）,流式细胞术检测外周血单个核细胞中Th17和Treg细胞在淋巴细胞亚群中CD₄⁺T细胞相对比值。结果 AIH组、CHB组、对照组ANA检出率分别为75.0%、13.3%与3.3%,差异具有统计学意义（P<0.05）,AIH组ANA滴度以1∶320为主,CHB组与对照组以低滴度为主,肝病相关抗体检出率分别为71.2%、11.7%与0%,差异具有统计学意义（P<0.05）;以正常对照组为参照组,ASMA、LKM-1、AMA-M2、LC、SLA/LP并联方式诊断AIH的敏感度为71.2%（37/52）,特异度为100%（60/60）,若以CHB为参照组,并联诊断AIH的敏感度为71.2%（37/52）,特异度为88.3%（53/60）,自身抗体对IAIHG简化AIH诊断贡献率为100%;AIH组Th17/CD₄⁺T较对照组高[0.92±0.38,0.68±0.29,P<0.05],Treg/CD₄⁺T较对照组低[2.23±0.59,4.86±1.26,P<0.05]。。结论肝病相关自身抗体对AIH的诊断价值较高,AIH患者存在Th17、Treg细胞平衡失调。更多还原

【Abstract】 Objective To investigate the clinical significance of the antoantibodies associated with liver disease and Th17,Treg cells in antoimmune hepatitis（ AIH）. Methods 52 cases of AIH were selected as experimental group,60 CHB patients were selected as the CHB group,and 60 cases for physical examination were collected as the control group. Indirect immunofluorescence assay was adopted for the detection of ANA and ASMA,and Western blot was used to detect ANAs and CHB related autoantibodies: LKM,M2,SLA/LP,LC-1,sp100,gp210 antibody. Flow cytometry was used to detect the relative ratio of Th17 and Treg cells in peripheral blood mononuclear cells to CD₄⁺T cells. Results The detection rates of ANA was 75. 0%,13. 3% and 3. 3% in AIH group,CHB group and control group,with the differences statistically significant（ P < 0. 05）. The titer of ANA in AIH was mainly 1∶320,while there was low titer in CHB group and control group. The detection rates of liver disease antibodies were 71. 2%,11. 7% and 0% respectively in the three groups,and the difference was statistically significant（ P < 0. 05）. The normal control group was used as the reference group. The parallel combination sensitivity of ASMA,LKM-1,AMA-M2,LC,SLA/LP antibodies was 71. 2%（ 37/52）,the specificity was 100%（ 60/60）. However,the sensitivity of AIH was 71. 2%（ 37/52）,and the specificity was 88. 3%（ 53/60） using CHB as the reference group. The contribution of autoantibodies to IAIHG diagnosis was 100% in AIH. The relative values of Th17/CD₄⁺T in AIH group were higher than controls[0. 92 ± 0. 38,0. 68 ± 0. 29,P < 0. 05],and the Treg/CD₄⁺T cells were lower than the concontrol obviously[2. 23 ± 0. 59,4. 86 ± 1. 26,P < 0. 05]. Conclusion The diagnostic value of the liver disease associated autoantibodies to AIH is high,and the imbalance of the Th17/Treg cell existed in AIH patients.更多还原