【摘要】 目的 探讨血清抗-去唾液酸糖蛋白(ASGPR)抗体在自身免疫性肝炎(AIH)诊断中价值，筛选可用于AIH诊断的血液检测指标，并构建整合性诊断模型。方法 回顾性分析苏州市第五人民医院2023年9月至2024年12月间接受肝穿刺活检的患者159例，包括AIH(63例)、脂肪肝(38例)、病毒性肝炎(22例)、药物性肝损伤(15例)及其他肝脏疾病(21例),另从2024年7月的体检者中筛选出的健康对照22例。检测研究对象血清中的抗-ASGPR抗体、自身抗体、细胞角蛋白18-M30/65(CK18-M30/65)及生化、凝血等指标。通过组间比较筛选AIH诊断的关键因子，并采用二元Logistic回归分析构建诊断模型。结果 与健康对照组比较，仅AIH组血清抗-ASGPR抗体水平显著升高，差异有统计学意义(P=0.009)。在AIH组与非AIH组的比较中，筛选出天冬氨酸氨基转移酶(AST)、免疫球蛋白G(IgG)和直接胆红素作为关键诊断因子。进一步联合血清抗-ASGPR抗体和上述3项生化检测指标构建AIH诊断模型，其曲线下面积(AUC)为0.813(95%CI:0.738～0.887),灵敏度为61.0%,特异性为96.1%,诊断正确率为77.0%。结论 基于血清抗-ASGPR抗体，AST、IgG和直接胆红素这3项临床常规指标所构建的诊断模型，对AIH具有良好的鉴别能力，可作为简便、实用的辅助诊断工具。更多还原

【Abstract】 Objective To investigate the diagnostic value of serum anti-asialoglycoprotein receptor(ASGPR) antibody in autoimmune hepatitis(AIH), and to screen for potential blood biomarkers for AIH diagnosis, and to further develop an integrated diagnostic model. Methods A retrospective analysis was conducted within 159 patients who underwent liver biopsy at the Fifth People’s Hospital of Suzhou between September 2023 and December 2024, including 63 AIH cases, 38 with fatty liver disease, 22 with viral hepatitis, 15 with drug-induced liver injury, and 21 with other liver conditions. Additionally, 22 healthy controls were selected from individuals undergoing health examinations in July 2024. Serum levels of anti-ASGPR antibody, autoantibodies, cytokeratin 18-M30/65(CK18-M30/65), biochemical parameters, and coagulation markers were measured in all subjects. Key diagnostic factors for AIH were identified through intergroup comparisons, and a diagnostic model was developed based on binary logistic regression analysis. Results Compared with the healthy control group, only AIH group showed a statistically significant increase in serum anti-ASGPR antibody levels(P=0.009). Comparative analysis between the AIH and non-AIH groups identified aspartate aminotransferase(AST), immunoglobulin G(IgG), and direct bilirubin as key diagnostic factors. A diagnostic model integrating serum anti-ASGPR antibody with these three biochemical indicators demonstrated an area under the curve(AUC) of 0.813(95%CI:0.738-0.887), with a sensitivity of 61.0%, specificity of 96.1%, and overall diagnostic accuracy of 77.0%. Conclusion The diagnostic model based on serum anti-ASGPR antibody combined with three readily available clinical parameters(AST, IgG, and direct bilirubin) demonstrates a good discriminatory power for AIH and can serve as a convenient and practical auxiliary diagnostic tool.更多还原