抗核抗体和自身免疫性肝病相关抗体检测在原发性胆汁性肝硬化诊断中的价值

目的探讨抗核抗体(ANA)和自身免疫性肝病相关抗体联合检测在原发性胆汁性肝硬化诊断中的价值。方法选取2012年7月—2013年12月住院的原发性胆汁性肝硬化患者40例作为观察组,86例非自身免疫性肝病患者为对照组。采用间接免疫荧光法检测患者血清ANA,采用免疫印迹法检测抗线粒体抗体(AMA)、SP100、SLA/LP、LC-1、LK-M、gp-210,分析其诊断价值。结果观察组患者AMA检出率为95.00%(38/40),明显高于对照组的5.81%(5/86)(χ²=6.25,P<0.05)。ANA中的着丝点型、核膜型及核多点型检出率分别为35.00%(14/40)、30.00%(12/40)和22.50%(9/40),明显高于对照组的11.630k(10/86)、5.81%(5/86)和3.49%(3/86)(χ2=6.25,P<0.05)。ANA中的着丝点型、核膜型及核多点型检出率分别为35.00%(14/40)、30.00%(12/40)和22.50%(9/40),明显高于对照组的11.630k(10/86)、5.81%(5/86)和3.49%(3/86)(χ²=2.725、6.780、2.876,P<0.05)。观察组SP100、SLA/LP、LC-1、LK-M、gp-210检出率明显高于对照组(分别为30.00%、22.50%、17.50%、10.00%、15.00%vs.3.490k、1.16%、4.65%、2.33%、3.49%,均P<0.05)。ANA检测观察组灵敏度和特异度及符合率分别为92.500k(37/40)、87.50%(35/40)、95.00%(38/40),明显高于对照组的84.88%(73/86)、77.91%(67/86)、87.21%(75/86)(P<0.05)。结论临床采用ANA和自身免疫性肝病相关抗体谱联合检测,可提高原发性胆汁性肝硬化的临床检出率,为其诊断和治疗提供重要的参考价值。

Evaluation of ANA and autoimmune liver disease associated antibodies in diagnosis of primary biliary cirrhosis

Objective To investigate the anti-nuclear antibody （ANA） and autoimmune hepatitis antibodies in detection of primary biliary cirrhosis. Methods From July 2012 to December 2013, hospitalized patients with primary biliary cirrhosis of 40 cases were enrolled as the observation group, 86 patients with non-antoimmune liver disease patients as control group. Anti-nuclear antibodies in the sera of patients were detected by indirect immunofluorescence （ANA）, Western blot was used to detect anti mitochondrial antibody （AMA） , SP100,SLA/LP,LC-1, LK-M, gp-210, analyzed the diagnostic value of them. Results In the observation group, AMA positive rate was 95.00% （38/40）, significantly higher than that in the control group of 5.81% （5/86） （X2 = 6.25, P 〈 0.05 ）, ANA＇ s the eentromere type, nuclear membrane and nuclear multi point detection rates were 35.00% （14/40） , 30.00% （12/40） and 22.50% （9/40） , significantly higher than the control group with 11.63% （10/86）, 5.81% （5/86） and 3.49% （3/86） （X2 =2.725,6.780,2.876, P 〈0.05）. The observation group＇s SP-100, SLA/LP, LC-1, LK-M, gp-210 positive rate were obviously higher than those of the control group （30.00% , 22.50% , 17.50% , 10.00% , 15.00% vs. 3.49%, 1.16% , 4.65%, 2.33% , 3.49% , P 〈0.05）. The observation group＇ s sensitivity, specificity and coincidence rate was 92.50% （37/40） , 87.50% （35/40） , 95.00% （ 38/ 40） , which were significantly higher than the control group with 84.88% （73/86）, 77.91% （67/86）, 87.21% （75/86） （P 〈 0.05）. Conclusion Clinical application of ANA and autoimmune hepatitis antibody spectrum joint detection can im- prove the detection rate of clinical primary biliary cirrhosis, provides important reference value for the diagnosis and treatment.