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目的分析原发性胆汁化肝硬化(PBC)患者的自身抗体谱和免疫功能,探讨其对PBC的诊断价值。方法用免疫印迹法检测107例PBC、100例疾病对照组和30例健康体检者血清中的抗线粒体抗体(AMA)M2亚型、AMAM2-3E(BPO)、抗Spl00抗体、抗gp210抗体、抗肝肾微粒体1型(LKM-1)抗体、抗早幼粒细胞性白血病(PML)抗体、抗肝特异性胞质抗体-1(LC-1)、抗可溶性肝抗原/肝胰抗原抗体(SLA/LP)。结果 1.AMA-M2、AMAM2-3E(BPO)、抗Spl00抗体、抗PML抗体、抗gp210抗体对PBC诊断的敏感性、特异性分别为74.7%、90.2%,86.9%、95.1%,32.7%、97.1%,27.1%、97.5%,39.3%,98.3%。未检测到抗LKM-1抗体、抗LC-1抗体、抗SLA/LP抗体。2.在118例疾病对照组中AMA-M2、AMAM2-3E(BPO)、抗Spl00抗体、抗PML抗体、抗gp210抗体检出率分别为16%、11%、3%、1%、3%,未检测到抗LKM-1抗体、抗LC-1抗体、抗SLA/LP抗体。在正常对照组上述8种抗体的检出率均为0。3.AMA-M2呈阳性的患者(n=97)比呈阴性的患者(n=10)有更加严重的疾病。这可通过更加严重的组织学变化和更高的IgG,IgM和ALP平均值看出;抗gp210抗体呈阳性的患者肝功能衰竭发生率明显高于呈阴性的患者(P<0.05)。结论 PBC患者血清中可检测到多种自身抗体,其中抗Spl00抗体、抗PML抗体、抗gp210抗体在PBC诊断中特异性高,可协助诊断PBC。
Objective To analyze the autoantibody profile and immune function of patients with primary biliary cirrhosis (PBC) and to explore its diagnostic value for PBC. Methods The serum level of anti-mitochondrial antibody (AMA) M2, AMAM2-3E (BPO), anti-Spl00 antibody, anti-gp210 antibody and anti-Sp2 antibody in 107 PBC patients, 100 disease control patients and 30 healthy controls were detected by Western blotting. LKM-1 antibody, anti-promyelocytic leukemia (PML) antibody, anti-liver specific cytosol-1 (LC-1), anti-soluble liver antigen / hepatopancreas antigen antibody SLA / LP). The sensitivity, specificity of AMA-M2, AMAM2-3E (BPO), anti-Spl00 antibody, anti-PML antibody and anti-gp210 antibody in the diagnosis of PBC were 74.7%, 90.2%, 86.9%, 95.1%, 32.7% , 97.1%, 27.1%, 97.5%, 39.3%, 98.3%. Anti-LKM-1 antibody, anti-LC-1 antibody, anti-SLA / LP antibody were not detected. The detection rates of AMA-M2, AMAM2-3E (BPO), anti-Spl00, anti-PML and anti-gp210 in 118 disease control groups were 16%, 11%, 3%, 1%, 3% , No anti-LKM-1 antibody, anti-LC-1 antibody, anti-SLA / LP antibody were detected. In the normal control group, the detection rates of the above eight antibodies were all 0.3. Patients with positive AMA-M2 (n = 97) had more severe disease than those with negative (n = 10). This can be seen by more serious histological changes and higher averages of IgG, IgM and ALP; patients with an anti-gp210 antibody were significantly more likely to have liver failure than those who were negative (P <0.05). Conclusion There are many kinds of autoantibodies detected in sera of patients with PBC. Anti - Spl00 antibody, anti - PML antibody and anti - gp210 antibody are highly specific in the diagnosis of PBC and can be used to diagnose PBC.