【摘要】 目的分析原发性胆汁性肝硬化(PBC)患者出现的抗线粒体抗体(AMA)和抗核抗体(ANA)及其特征。方法对58例确诊的PBC患者采用间接免疫荧光法(IFA)检测AMA、ANA,进一步采用酶联免疫吸附试验(ELISA)和免疫条带法分别检测AMA和ANA的亚型抗体。结果58例PBC患者AMA抗体均为阳性,89.2%的患者AMA的滴度≥1∶320;AMA亚型M2、M4和M9的检出率分别为100%、75.9%和24.1%。M2≥200 RU/L的患者丙氨酚转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转氨酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TB il)明显高于M2<200 RU/L的患者。M4阳性组ALT、AST明显高于M4阴性组。25.9%的患者出现了ANA,ANA的主要荧光模式为着丝点型11例、核膜型9例、核点型5例,集中出现在AMA高滴度以及M2≥200RU/L的患者。结论PBC患者一般均有高水平的AMA和M2,且滴度和病情相关。M4、M9在PBC有一定的检出率。多数PBC患者还伴有高滴度的ANA并有主要的荧光模式。更多还原

【Abstract】 Objective To investigate the prevalence of anti-mitochondrial antibody(AMA) and anti-nuclear antibodies(ANA) in patients with primary biliary cirrhosis(PBC) and analyze their characteristics. Methods 58 PBC patients were examined for AMA and ANA by immunofluorescent assay(IFA).Subtypes of AMA(M2,M4,M9) and ANA profile were detected by immune blotting assay and enzyme linked immunosorbent assay(ELISA) respectively. Results All PBC patients were positive for AMA,and 89.2% showed high titer (≥(1∶320)).The positive rate of M2,M4 and M9 was 100%,75.9% and 24.1% respectively.alanine aminofransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(GGT),alkaline phosphatase(ALP) and total bilirubin(TBil) in patients with M2≥200 RU/L were markedly higher than those in patients with M2<200 RU/L,ALT and AST in M4 positive patients were markedly higher than those in patients with M4 negative patients. About 75.9% PBC patients were ANA positive and showed 3 main fluorenscent patterns: 11 of nuclear membrane,9 of nuclear dots and 5 of centromere,which frequently present in patients with high titer of AMA or in patients with M2≥200 RU/L. Conclusions Most of the PBC patients show high levels of AMA with particular positive rates of M2 and M4 which might be related to the activities of disease.There were also high title of ANA in PBC patients with special fluorenscent patterns.更多还原